OMB control number

WISEWOMAN National Program Evaluation: Implementation Assessment

OMB 0920-1068 · HHS/CDC.

OMB 0920-1068

Latest forms, documents, and information collections
Document	Type
Private Sector	Form
(Private Sector) Awardee Partners Discussion Guide	Form
(Private Sector) Awardee Partners Network Survey	Form
Clinical Providers	Form
Healthy Behavior Support Staff Site Visit Discussion Guide	Form
Awardee Partners Site Visit Discussion Guide	Form
Awardee Partners Network Survey	Form
Awardee Administrators Site Visit Discussion Guide	Form
Awardee Administrators Network Survey	Form
Awardee Administrators Program Survey	Form
Attachment B proposed outcomes and measures_5 27 2015.docx	Supplementary Document
Attachment B proposed outcomes and measures.docx	Supplementary Document
Attachment E5 Consent form.docx	Supplementary Document
IRB exempt.pdf	Supplementary Document
Attachment F2 Summary of Public Comments.docx	Supplementary Document
Attachment F1 Federal Register Notice.pdf	Supplementary Document
Attachment A1 A2 authorizing legislation.pdf	Supplementary Document
WISEWOMAN OMB Part B_11 07 2014.docx	Supporting Statement B
WISEWOMAN OMB Part A_5 27 2015.docx	Supporting Statement A
Private Sector	Form
(Private Sector) Awardee Partners Discussion Guide	Form
(Private Sector) Awardee Partners Network Survey	Form
Clinical Providers	Form
Healthy Behavior Support Staff Site Visit Discussion Guide	Form
Awardee Partners Site Visit Discussion Guide	Form
Awardee Partners Network Survey	Form
Awardee Administrators Site Visit Discussion Guide	Form
Awardee Administrators Network Survey	Form
Awardee Administrators Program Survey	Form

Historical document collections
Reference	Filing	Received	Concluded	Action
201412-0920-005	New collection (Request for a new OMB Control Number)	2014-12-22		Approved with change