OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

The HRSA Community Based Outreach Reporting Module

OMB 0906-0064 ยท HHS/HRSA.

OMB 0906-0064

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 4 Community Based Vaccine Outreach Program Reporting Module - Booster Vaccines 09-22-2021.docxForm and Instruction
Form 4 Vaccine Site Data - Outreach to Community Members Form - Booster VaccinesForm and Instruction
Form 3 General Outreach Activities for Community Members FormForm and Instruction
Form 3 General Outreach Activities for Community Members FormForm and Instruction
Form 2 Vaccine Site Data - Outreach to Community Members FormForm and Instruction
Form 2 Vaccine Site Data - Outreach to Community Members FormForm and Instruction
Form 1 Community Outreach Worker Profile FormForm and Instruction
Form 1 Community Outreach Worker Profile FormForm and Instruction
Supporting Statement A - CBO Program FINAL 09-22-2021.docxSupporting Statement A
Transmittal Memo to OIRA from HRSA CBO PRA Approval Request 07.09.2021 approved.pdf Supplementary Document
Vaccine Site Data - Outreach to Community Members Form - Booster Vaccines Form and Instruction
Vaccine Site Data - Outreach to Community Members Form - Booster Vaccines Form and Instruction
General Outreach Activities for Community Members Form Form and Instruction
General Outreach Activities for Community Members Form Form and Instruction
Vaccine Site Data - Outreach to Community Members Form Form and Instruction
Vaccine Site Data - Outreach to Community Members Form Form and Instruction
Community Outreach Worker Profile Form Form and Instruction
Community Outreach Worker Profile Form Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202109-0906-002 Revision of a currently approved collection 2021-09-30 Approved without change
202107-0906-001 New collection (Request for a new OMB Control Number) 2021-07-12 Approved without change