OMB control number
State Office of Rural Health Grant Technical Assistance
OMB 0915-0322 · HHS/HSA.
OMB 0915-0322
FORHP seeks to continue gathering information from grantees on their efforts to provide technical assistance to clients within their State. SORH grantees submit a Technical Assistance Report that includes: (1) the total number of technical assistance encounters provided directly by the grantee; and, (2) the total number of unduplicated clients that received direct technical assistance from the grantee. These measures will continue in these three categories: (1) information disseminated, (2) information created, and (3) collaborative efforts by a) topic area and b) type of audience. These measures are used to obtain an accurate depiction of the breadth of SORH work, based on recommendations from the grantees. Submission of the Technical Assistance Report is submitted via the HRSA Electronic Handbook no later than 60 days after the end of each twelve month budget period. Likely Respondents: Fifty (50) State Offices of Rural Health award recipients.
The latest form for State Office of Rural Health Grant Technical Assistance expires 2029-06-30 and is listed under ICR 202604-0915-003.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 1 Instrument - 0915-0322 - FORHP - SORH Collection Tool - Revision - 04172026.docx | Form and Instruction |
| SORH 30 Day FRN Supporting Statement A (OMB).docx | Supporting Statement A |
 State Offices of Rural Health TA Data Collection Form |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202604-0915-003 | Revision of a currently approved collection | 2026-04-24 | ||
| 202303-0915-002 | Extension without change of a currently approved collection | 2023-03-17 | Approved without change | |
| 201912-0915-002 | Revision of a currently approved collection | 2019-12-19 | Approved with change | |
| 201608-0915-002 | Extension without change of a currently approved collection | 2016-08-25 | Approved with change | |
| 201307-0915-004 | Extension without change of a currently approved collection | 2013-07-11 | Approved without change | |
| 201006-0915-001 | Extension without change of a currently approved collection | 2010-06-07 | Approved without change | |
| 200810-0915-001 | New collection (Request for a new OMB Control Number) | 2008-10-03 | Approved with change |