PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
2024 Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Evaluation Surveys
New
1960
102
0
Form
1
Conference Evaluation Survey
Collection of Qualitative Feedback on Telehealth.HHS.gov
New
17465
99
0
Form and Instruction
1
Telehealth Website - Page Level - SurveyEngSpan
Form and Instruction
2
Telehealth Website - Site Level - Survey EngSpan
Division of Grants Management Operations Customer Service Satisfaction Survey
New
768
92
0
Form
1
DGMO Customer Service Survey Questions
Division of Independent Review Objective Review Assessment Survey
New
2300
575
0
Form and Instruction
1.1
Screenshot Reviewer Instr
Form
2
Form Chair Q 1-5
Form
1
FORM Reviewer Evaluation Q 1- 15
Form and Instruction
1.2
FORM Reviewer Evaluation-Field Review Q 1 - 12
Other-Public Burden Statement Screenshot
Early Childhood Systems Technical Assistance and Coordinating Center Customer Satisfaction Surveys
New
320
79
0
Form and Instruction
A
Attachment A_ECS TACC Community of Practice Surve
Form and Instruction
B
Attachment B_ECS TACC Webinar Survey
Form and Instruction
C
Attachment C_ECS TACC TA Resources Products Survey
Form and Instruction
Attachment D
Attachment D_ECS TACC Semi-Annual Interview Protocol
Evaluation Survey of Eligible National Practitioner Data Bank Entity Users: Relevance of Information Collected via NPDB Query Forms
New
900
150
0
Form and Instruction
1
Query Survey Intro-Instructions
Form and Instruction
2
User Survey Questions - Query
HRSA Electronic Handbooks Customer Service Survey
New
5000
40
0
Form and Instruction
1
EHB Customer Support Center Survey Screenshot
HRSA Web Survey
New
16667
833
0
Form
1
English Language Survey
Form
2
Spanish Language Survey
Health Center Program Support Customer Service Survey
New
800
40
0
Form and Instruction
1
EHBs Customer Support Center Survey Screenshot
Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys
New
665
70
0
Form
1
Annual Awardee Survey
Form
2
Instrument B_Post Webinar Survey
Form and Instruction
3
Post Learning Collaborative Survey
Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys
New
2230
209
0
Form
1
Attachment A_Individualized Targeted TA Check in
Form
2
Attachment B_Individualized Targeted TA Closeout
Form
3
Attachment C_Project Officer Survey
Form
4
Attachment D_Webinar Survey
Form
5
Attachment E_Community of Practice Survey
Form
6
Attachment F_Leadership Academy Session Survey
Form
7
Attachment G_Leadership Academy Completion Survey
Form
8
Attachment H_Quarterly Overall TA Survey
Form
9
Attachment I_CQI Practicum Check in Survey
Form
10
CQI Practicum Completion Survey
Maternal, Infant, and Early Childhood Home Visiting Program On-Site Compliance Review Awardee Feedback Form
New
315
79
0
Form
1
On Site Compliance Review Awardee Feedback Form
Maternal, Infant, and Early Childhood Home Visiting Site Visit Awardee Feedback Form
New
270
68
0
Form and Instruction
1
Instrument A MIECHV Site Visit Compliance Review Awardee Feedback Form Boilerplate
Form and Instruction
A
Instrument A MIECHV Site Visit Compliance Review Awardee Feedback Form
National Marrow Donor Program Donation Experience Survey
New
1672
217
0
Form and Instruction
1
Donation Experience Survey
National Practitioner Data Bank Usability Survey
New
200
200
0
Form and Instruction
1
0915-0212_UsabiltyTesting Instrument_NPDBSystem
Title V Information System User Satisfaction Survey
New
70
12
0
Form and Instruction
1
Screen Shots of Title V Information System Survey 2021
Tree Testing of HRSA's Ryan White HIV/AIDS Program website
New
50
25
0
Other-Tree Test Plan
Form
1
Tree Test Script
Total Burden Actually Used for Information Collections Under Currently Approved ICR:
51652
2890
0
Total Burden Currently Requested for Information Collections Under Currently Approved ICR:
0
0
0
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