OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

OMB 0915-0212 · HHS/HSA.

OMB 0915-0212

This generic project clearance allows HRSA to conduct voluntary customer satisfaction surveys of its partners to assess strengths and weaknesses in program services and products. Examples of such surveys include satisfaction with technical assistance provided to grantees, in class evaluations of training sessions, and satisfaction with information services.

The latest form for Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration expires 2021-07-31 and is listed under ICR 202012-0915-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 1 HRSA Web SurveyForm
Form 1 Title V Information System User Satisfaction SurveyForm and Instruction
Form 1 Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction SurveysForm
Form 1 Collection of Qualitative Feedback on Telehealth.HHS.govForm and Instruction
Form 1 National Practitioner Data Bank Usability SurveyForm and Instruction
Form 1 Evaluation Survey of Eligible National Practitioner Data Bank Entity Users: Relevance of Information Collected via NPDB Query FormsForm and Instruction
Form 1 National Marrow Donor Program Donation Experience SurveyForm and Instruction
Form 1 Maternal, Infant, and Early Childhood Home Visiting Site Visit Awardee Feedback FormForm and Instruction
Form 1 Maternal, Infant, and Early Childhood Home Visiting Program On-Site Compliance Review Awardee Feedback FormForm
Form 1 2024 Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Evaluation SurveysForm
Form 1 Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction SurveysForm
Form 1 Health Center Program Support Customer Service SurveyForm and Instruction
Form 1 HRSA Electronic Handbooks Customer Service SurveyForm and Instruction
Form A Early Childhood Systems Technical Assistance and Coordinating Center Customer Satisfaction SurveysForm and Instruction
Form 1.1 Division of Independent Review Objective Review Assessment SurveyForm and Instruction
Form 1 Division of Grants Management Operations Customer Service Satisfaction SurveyForm
Focus Group Example_Screening Questions.docx Supplementary Document
Focus Group Example_Informed Consent.docx Supplementary Document
Focus Group Example_Focus Group Guide.docx Supplementary Document
Supporting Statement B 12.8.23.docxSupporting Statement B
Supporting Statement A 12.8.23.docxSupporting Statement A
HRSA Web Survey Form
Title V Information System User Satisfaction Survey Form and Instruction
Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys Form
Tree Testing of HRSA's Ryan White HIV/AIDS Program website Other-Tree Test Plan
Collection of Qualitative Feedback on Telehealth.HHS.gov Form and Instruction
National Practitioner Data Bank Usability Survey Form and Instruction
Evaluation Survey of Eligible National Practitioner Data Bank Entity Users: Relevance of Information Collected via NPDB Query Forms Form and Instruction
National Marrow Donor Program Donation Experience Survey Form and Instruction
Maternal, Infant, and Early Childhood Home Visiting Site Visit Awardee Feedback Form Form and Instruction
Maternal, Infant, and Early Childhood Home Visiting Program On-Site Compliance Review Awardee Feedback Form Form
2024 Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Evaluation Surveys Form
Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys Form
Health Center Program Support Customer Service Survey Form and Instruction
HRSA Electronic Handbooks Customer Service Survey Form and Instruction
Early Childhood Systems Technical Assistance and Coordinating Center Customer Satisfaction Surveys Form and Instruction
Division of Independent Review Objective Review Assessment Survey Form and Instruction
Division of Grants Management Operations Customer Service Satisfaction Survey Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202401-0915-004 Revision of a currently approved collection 2024-01-10 Approved without change
202401-0915-001 No material or nonsubstantive change to a currently approved collection 2024-01-04 Approved without change
202312-0915-001 No material or nonsubstantive change to a currently approved collection 2023-12-14 Approved without change
202308-0915-005 No material or nonsubstantive change to a currently approved collection 2023-08-17 Approved without change
202103-0915-002 Extension without change of a currently approved collection 2021-03-16 Approved without change
202012-0915-001 No material or nonsubstantive change to a currently approved collection 2020-12-08 Approved without change
201506-0915-001 Extension without change of a currently approved collection 2018-05-15 Approved with change
201502-0915-002 Extension without change of a currently approved collection 2015-03-12 Approved without change
201206-0915-002 Revision of a currently approved collection 2012-06-08 Approved with change
200904-0915-002 Extension without change of a currently approved collection 2009-04-27 Approved without change
200809-0915-001 No material or nonsubstantive change to a currently approved collection 2008-09-03 Approved without change
200709-0915-002 No material or nonsubstantive change to a currently approved collection 2007-09-23 Withdrawn and continue
200707-0915-004 No material or nonsubstantive change to a currently approved collection 2007-07-30 Withdrawn and continue
200603-0915-001 Extension without change of a currently approved collection 2006-03-20 Approved without change
200302-0915-001 Extension without change of a currently approved collection 2003-02-05 Approved without change
200002-0915-004 Extension without change of a currently approved collection 2000-02-24 Approved without change
199702-0915-001 New collection (Request for a new OMB Control Number) 1997-02-03 Approved without change

OMB Details

Building Futures: Supporting Youth Living with HIV, Feedback on Toolkit and Webinars

Federal Enterprise Architecture: Health - Health Care Services

Information collection instruments
FormNameElectronic accessType
Form 1BF_Webinar_Survey_4_24_2018.docx Fillable FileableForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.