OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Survey of Medical Care Providers for the Evaluation of the Regional Extension Center (REC) Program

OMB 0955-0015 · HHS/ONC.

OMB 0955-0015

Latest Forms, Documents, and Supporting Material

Document Name
0955-0015_nonsubstantive change request 072514 memo.docx Justification for No Material/Nonsubstantive Change
20475 ID_Supporting Statement Part B 120513.doc Supporting Statement B
20745 ID_ REC Supporting Statement A 120513.doc Supporting Statement A
Practice Managers Form C Shortened Survey Administered on Paper Other-survey
Nurses Form C Shortened Survey Administered on Paper Other-survey
Physicians Form C Shortened Survey Administered on Paper Other-survey
Practice Managers Form B Survey Administered as a Computer-Assisted Telephone Interview Other-Survey
Nurses Form B Survey Administered as a Computer-Assisted Telephone Interview Other-Survey
Physicians Form B Survey Administered as a Computer Assisted Telephone Interview Other-Survey
Practice Managers Form A Screener Administered on Paper Other-screener
Nurses Form A Screener Administered on Paper Other-screener
Physicians Form A Screener Administered on Paper Other-survey

All Historical Document Collections

201407-0955-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2014-07-29
201312-0955-001 Approved without change	New collection (Request for a new OMB Control Number)	2013-12-23