Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Evidence Based Telehealth Network Program Report Modified 44 1364 0 Form and Instruction 1 RTRC Data Element Dictionary
Instruction
Other-Supplemental
Telehealth Performance Measurement Report Modified 11 55 0 Form and Instruction 1 Evidence-Based Telehealth Network Program_Data Dictionary
Form and Instruction 1.1 EP TNP PIMS Template
Total burden requested under this ICR: 55 1419 0  
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