OMB control number

Promoting Telehealth for Low-Income Consumers; COVID-19 Telehealth Program

OMB 3060-1271 · FCC.

OMB 3060-1271

This information collection extends the existing requirements for both the Connected Care Pilot Program and the COVID-19 Telehealth Program.

The latest form for Promoting Telehealth for Low-Income Consumers; COVID-19 Telehealth Program expires 2028-08-31 and is listed under ICR 202504-3060-005.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form FCC Form 460 Description of Eligibility and Registration	Form
Form FCC Form 460 Federal Government	Form
Form FCC Form 463 Description of Request for Funding Disbursement	Form
Form FCC Form 462 Request for Funding	Form
Form FCC Form 461 Request for Services	Form
Post-Commitment Request Form	Form
COVID-19 Telehealth Request for Reimbursement Form	Form
COVID-19 Telehealth Program Application Form	Form
Business or other for-profit	Form
3060-1271 - SS _May final version.docx	Supporting Statement A
Federal Government	Form
Federal Government	Form
Federal Government	Other-CMHC Checklist
State, Local or Tribal Governments	Form
State, Local or Tribal Governments	Form
State, Local or Tribal Governments	Form
State, Local or Tribal Governments	Other-COVID-19, Telehealth Program, LOA
Business or other for-profit	Form
Business or other for-profit	Form
Business or other for-profit	Form
Business or other for-profit	Form
Business or other for-profit	Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202504-3060-005	Revision of a currently approved collection	2025-05-29
202206-3060-014	Revision of a currently approved collection	2022-06-23	Approved without change
202102-3060-006	No material or nonsubstantive change to a currently approved collection	2021-02-04	Approved without change
202012-3060-017	No material or nonsubstantive change to a currently approved collection	2020-12-31	Approved without change
202012-3060-011	No material or nonsubstantive change to a currently approved collection	2020-12-28	Approved without change
202008-3060-005	Revision of a currently approved collection	2020-08-27	Approved without change
202004-3060-010	New collection (Request for a new OMB Control Number)	2020-04-03	Approved with change

OMB Details

Business or other for-profit

Federal Enterprise Architecture: Health - Health Care Services

Information collection instruments
Form	Name	Electronic access	Type
Form N/A	Post-Commitment Request Form	Fillable Fileable Signable	Form
Form N/A	COVID-19 Telehealth Request for Reimbursement Form	Fillable Fileable Signable	Form
Form N/A	COVID-19 Telehealth Program Application Form	Fillable Fileable Signable	Form

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