Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2016 National Ryan White Conference on HIV Care and Treatment Conference Evaluation New 2069 1490 0 Form and Instruction 1
Other-Example
BPHC Customer Service Survey Helpline & Answers New 2315 19 0 Form 1
Form 2
Bullying Prevention Training Modules Feedback Forms New 500 100 0 Form and Instruction 1
Form and Instruction 2
Customer Satisfaction Surveys for the Health Literacy Training Program New 2600 225 0 Form 1
Form 2
DATA CoIIN New 340 27 0 Form 1
DPDB Usability Surveys New 300 300 0 Form 1
Form 2
Instruction
Data and Technical Assistance (DATA) Task Order to Support the Infant Mortality CoIIN New 2670 214 0 Form 1
Form 2
Form 3
Discussion on Teen Organ Donors New 124 71 0 Form and Instruction 1
Form and Instruction 2
Form and Instruction 3
Discussions on 50+ Donors New 124 71 0 Form and Instruction 2
Form and Instruction 3
Form and Instruction 5
Form and Instruction 6
HRSA Division of Transplanation (DoT Research on Customer Information Needs Related to Vascularized Composite Allographs Transplants New 724 174 0 Form and Instruction 1
Form and Instruction 2
HRSA Electronic Handbooks Customer Service Survey New 4825 38 0 Form 1
HRSA Office of Acquisition Management and Policy (OAMP) Customer Satisfaction Survey New 864 18 0 Form 1
HRSA Office of Regional Operations (ORO) Outreach & Education Generic Survey Tool New 3000 501 0 Form 1
HRSA Survey Assessment of Objective Peer Review New 2158 540 0 Form 1
Form 2
HRSA, ACF, and HHS OWH Pilot on Intimate Partner Violence (IPV) Screening and Counseling in Health Centers and Domestic Violence Partner Organizations New 2124 531 0 Form and Instruction 1
Form and Instruction 2
Form and Instruction 3
Form and Instruction 4
Form and Instruction 5
Form and Instruction 6a
Form and Instruction 6b
Form and Instruction 7a
Form and Instruction 7b
MCH Connects Survey New 53 5 0 Form and Instruction 1
MCH Leadership Competencies New 150 45 0 Form and Instruction 1
Maternal and Child Health Epidemiology Training Course - One Year Follow-Up Survey New 40 10 0 Form 1
Maternal, Infant, and Early Childhood Home Visiting Program HV-ImpACT Technical Assistance Program Feedback and Satisfaction Surveys New 753 322 0 Form and Instruction A
Form and Instruction B
Form and Instruction C
Form and Instruction D
Maternal, Infant, and Early Childhood Home Visiting Program Technical Assistance Feedback and Satisfaction Surveys New 1650 508 0 Form and Instruction B
Form and Instruction C
Form and Instruction D
Form and Instruction E
NHSC Virtual Job Fair Customer Feedback New 96 16 0 Form and Instruction 1
Form and Instruction 2
Form and Instruction 3
Form and Instruction 4
ORO Dallas State Strategic Partnership Forum New 70 12 0 Form and Instruction 1
ORO-Dallas Virtual Participant Satisfaction Survey New 275 3 0 Form and Instruction 1
Office of Regional Operations (ORO) 2016 Tele-Behavioral Health Webcase Series New 90 15 0 Form 1
Opioid Addiction Treatment ECHO, Virtual Learning Community – Satisfaction Survey New 200 24 0 Form 1
Survey of Area Health Resource File Users (AHRF) New 100 7 0 Form and Instruction 1
Title V Information System User Satisfaction Survey (TVIS) New 177 30 0 Form and Instruction 1
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 28391 5316 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title