Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
BPHC Customer Service Survey Unchanged 1900 95 0 Form and Instruction 1
MIECHV TARC Satisfaction Survey Unchanged 967 145 0 Form and Instruction 1
Form and Instruction 2
Form and Instruction 3
Form and Instruction 4
Form and Instruction 5
Form and Instruction 6
Form and Instruction 7
Form and Instruction 9
Form and Instruction 8
Form and Instruction 10
2024 Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Evaluation Surveys Unchanged 1960 102 0 Form 1
2024 National Ryan White Conference on HIV Care & Treatment Evaluation Unchanged 937 325 0 Form 2
Form 3
Form and Instruction 1
Collection of Qualitative Feedback on Telehealth.HHS.gov Unchanged 17465 99 0 Form and Instruction 1
Form and Instruction 2
Collection of Qualitative Feedback on Telehealth.HHS.gov Unchanged 6600 48 0 Form 1
Form 2
DIR Objective Review Assessment Survey Unchanged 900 450 0 Instruction
Form and Instruction 1
Form and Instruction 2
Form and Instruction 3
Form and Instruction 1A
Form and Instruction 1B
Form and Instruction 1C
Form and Instruction 2A
Form and Instruction 2B
Form and Instruction 2C
Form and Instruction 2D
Form and Instruction 2E
Form and Instruction 2F
Form and Instruction 3A
Form and Instruction 3B
Form and Instruction 3C
Form and Instruction 3E
Form and Instruction 3D
Form and Instruction 3F
Form and Instruction 3G
Form and Instruction 3H
Division of Grants Management Operations Customer Service Satisfaction Survey Unchanged 768 92 0 Form 1
Division of Independent Review Objective Review Assessment Survey Unchanged 2300 575 0 Form and Instruction 1.1
Form 2
Form 1
Form and Instruction 1.2
Other-Public Burden Statement Screenshot
Division of Practitioner Data Bank (DPDB) Webinar Feedback and Satisfaction Surveys Unchanged 2400 200 0 Form 1
Early Childhood Systems Technical Assistance and Coordinating Center Customer Satisfaction Surveys Unchanged 320 79 0 Form and Instruction A
Form and Instruction B
Form and Instruction C
Form and Instruction Attachment D
Evaluation Survey of Eligible National Practitioner Data Bank Entity Users: Relevance of Information Collected via NPDB Query Forms Unchanged 900 150 0 Form and Instruction 1
Form and Instruction 2
Expanding Health Center Awareness of Sexual Assault-Related Health Care Needs (SATA) Evaluation New 582 104 0 Form and Instruction 1
Form and Instruction 2
Form and Instruction 3
Federal Cervical Cancer Collaborative (FCCC) CERV-Net Evaluation Unchanged 48 36 0 Form and Instruction 1
Form and Instruction 2
Form and Instruction 3
Follow up: ASPR/ Strategic National Stockpile (SNS) Dissemination and HRSA-Supported Health Centers use of JYNNEOS vaccine. New 100 8 0 Form 1
HRSA Electronic Handbooks Customer Service Survey Unchanged 5000 40 0 Form and Instruction 1
HRSA Web Survey Unchanged 16667 833 0 Form 1
Form 2
HRSA Web Survey Unchanged 16667 833 0 Form 1
Form 2
HRSA/HIV & AIDS Bureau (HAB) Recipients Satisfaction Survey (RSS). Unchanged 250 58 0 Form and Instruction 1
Health Center Program Support Customer Service Survey Unchanged 800 40 0 Form and Instruction 1
Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys Unchanged 2230 209 0 Form 1
Form 2
Form 3
Form 4
Form 5
Form 6
Form 7
Form 8
Form 9
Form 10
Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys Unchanged 665 70 0 Form 1
Form 2
Form and Instruction 3
Maternal, Infant, and Early Childhood Home Visiting Program On-Site Compliance Review Awardee Feedback Form Unchanged 315 79 0 Form 1
Maternal, Infant, and Early Childhood Home Visiting Site Visit Awardee Feedback Form Unchanged 270 68 0 Form and Instruction 1
Form and Instruction A
National Marrow Donor Program Donation Experience Survey Unchanged 1672 217 0 Form and Instruction 1
National Maternal Mental Health Hotline New 33000 9660 0 Instruction
Other-Data Dictionary
National Practitioner Data Bank Usability Survey Unchanged 200 200 0 Form and Instruction 1
Technical Assistance to Support the HHS Viral Hepatitis National Strategic Plan Unchanged 25 25 0 Other-Interview Questions
Title V Information System User Satisfaction Survey Unchanged 70 12 0 Form and Instruction 1
Tree Testing of HRSA's Ryan White HIV/AIDS Program website Unchanged 50 25 0 Other-Tree Test Plan
Form 1
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 116028 14877 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title