Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Annual Health Center Performance Measure Reporting Tool Modified 21 126 0 Form and Instruction 0920-1156
Form and Instruction 0920-1156
Annual Health Center Performance Measure Reporting Tool Modified 4 24 0 Form and Instruction 0920-1156
Form and Instruction 0920-1156
Awardee Performance Measure Reporting Tool Modified 3 3 0 Form and Instruction 0920-1156
Form and Instruction 0920-1156
Awardee Training and Techmnical Assistance Tool Modified 24 48 0 Form and Instruction 0920-1156
Health Center Organizational Assessment Modified 4 8 0 Form and Instruction 0920-1156
Form and Instruction 0920-1156
Health Center Organizational Assessment Modified 21 42 0 Form and Instruction 0920-1156
Form and Instruction 0920-1156
Health Center Provider Survey Modified 84 28 0 Form and Instruction 0920-1156
Form and Instruction 0920-1156
Health Center Provider Survey Modified 16 6 0 Form and Instruction 0920-1156
Form and Instruction 0920-1156
Health Center Youth Survey Removed 0 0 0 Form and Instruction NA
Quarterly Health Center Perfoemance Measure Reporting Tool Modified 8 32 0 Form and Instruction 0920-1156
Form and Instruction 0920-1156
Quarterly Health Center Performance Measure Reporting Tool Modified 42 168 0 Form and Instruction 0920-1156
Form and Instruction 0920-1156
Youth Serving Organization (YSO) Organizational Assessment Removed 0 0 0 Form and Instruction N/A
Form N/A
Youth Serving Organization (YSO) Organizational Assessment Removed 0 0 0 Form N/A
Youth Serving Organization (YSO) Performance Measure Reporting Tool Removed 0 0 0 Form N/A
Youth Serving Organization (YSO) Performance Measure Reporting Tool Removed 0 0 0 Form and Instruction NA
Youth Serving Organization (YSO) Staff Survey Removed 0 0 0 Form and Instruction N/A
Form N/A
Youth Serving Organization (YSO) Staff Survey Removed 0 0 0 Form and Instruction NA
Total burden requested under this ICR: 227 485 0  
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