ICR Documents

Document Date Uploaded
Final EOrev.Supporting Statement A.docx 04/18/2025

Document Date Uploaded
Supporting Statement B.docx 12/14/2023

Title Document Document Type Date Uploaded
60-Day Notice Evaluation of the Community Choice Demonstration 60-Day Notice.pdf Supplementary Document 10/19/2023
30-Day Notice 30-Day Notice The Community Choice Demonstration.pdf Supplementary Document 10/19/2023
Redline_Attachment G Mobility Services Tracking Tool EOrev.Redline.Attachment G Mobility Services Tracking Tool.pdf Supplementary Document 05/20/2025
Redline Attachment G_The Child Assessment & The Obesity and Type II Diabetes Risk Assessment_Assent. EOrev.Redline.Attachment G_The Child Assessment & The Obesity and Type II Diabetes Risk Assessment_Assent.pdf Supplementary Document 05/20/2025
Redline.Attachment I.1_The Child Assessment_Direct Child Assessment_Baseline. EOrev.Redline.Attachment I.1_The Child Assessment_Direct Child Assessment_Baseline.pdf Supplementary Document 05/20/2025
Redline.Attachment I.2_The Child Assessment_Direct Child Assessment_Follow-up EOrev.Redline.Attachment I.2_The Child Assessment_Direct Child Assessment_Follow-up.pdf Supplementary Document 05/20/2025
Redline.Attachment L_The Child and MOVED Assessments_Consent EOrev.Redline.Attachment L_The Child and MOVED Assessments_Consent.pdf Supplementary Document 05/20/2025
Redline.Attachment M.1_The Obesity Type II Diabetes Risk Assessment_Survey_Baseline Final EOrev.Attachment M.1_The Obesity Type II Diabetes Risk Assessment_Survey_Baseline.docx Supplementary Document 05/20/2025
Redline_Supporting Statement Part A EOrev.Supporting Statement A.pdf Supplementary Document 05/20/2025
Redline Attachment M.2_The Obesity Type II Diabetes Risk Assessment_Survey_Follow-up. EOrev.Redline.Attachment M.2_The Obesity Type II Diabetes Risk Assessment_Survey_Follow-up.pdf Supplementary Document 05/20/2025
EOrev. Form Revision Chart Template EOrev.Form Revision Chart Template.docx Justification for No Material/Nonsubstantive Change 05/20/2025

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