OMB control number
Family-to-Family Health Information Center (F2F HIC) Feedback Surveys
OMB 0906-0040 · HHS/HRSA.
OMB 0906-0040
The surveys will provide mechanisms to capture consistent, performance data; provide data to support the HHS Secretary's priorities of engagement; and allow HRSA to determine the extent to which F2F HICs provide service. F2F HICs can also use the data to evaluate the effectiveness of their interventions and improve services. Respondents are family members of children with special health care needs and professionals who serve such families.
The latest form for Family-to-Family Health Information Center (F2F HIC) Feedback Surveys expires 2022-03-31 and is listed under ICR 201910-0906-002.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 2 Family-to-Family Health Information Center Feedback Surveys | Form and Instruction |
| Form 1 Family-to-Family Health Information Centers Data Submission Form | Form and Instruction |
| FeedbackSurvey_GrantRecipient_Instructions Final clean.docx | Supplementary Document |
 Attachment - F2F 60 Day FRN.pdf | Supplementary Document |
| Supporting Statement B Final.docx | Supporting Statement B |
| Supporting Statement A Final.docx | Supporting Statement A |
 Family-to-Family Health Information Center Feedback Surveys |
Form and Instruction |
| Family-to-Family Health Information Centers Data Submission Form |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202201-0906-001 | Extension without change of a currently approved collection | 2022-01-18 | Approved with change | |
| 201910-0906-002 | No material or nonsubstantive change to a currently approved collection | 2019-10-10 | Approved without change | |
| 201812-0906-001 | New collection (Request for a new OMB Control Number) | 2018-12-10 | Approved with change |
OMB Details
Family-to-Family Health Information Centers Data Submission Form
Federal Enterprise Architecture: Health - Public Health Monitoring
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form 1 | F2F HIC DataSubmission_Form.docx | Fillable Fileable | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.