View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Home care for non health care providers questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form #7 Home care for non health care providers questionnaire Attachment 76 -- MPC Home Care for Non-health Care Providers Questionnaire.doc Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

23 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 152 0 0 0 0 152
Annual IC Time Burden (Hours) 13 0 0 0 0 13
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment 81 -- MPC Home Health Fax or Mail Return Form Attachment 81 -- MPC Home Health Fax or Mail Return Form.doc 08/24/2009
Attachment 78 -- MPC Home Health Cover Letter Attachment 78 -- MPC Home Health Cover Letter.doc 08/24/2009
Attachment 79 -- MPC Home Health FAQs BROCHURE Attachment 79 -- MPC Home Health FAQs BROCHURE.doc 08/24/2009
Attachment 80 -- MPC Home Health Fax Cover Sheet Attachment 80 -- MPC Home Health Fax Cover Sheet.doc 08/24/2009
Attachment 83 -- MPC Home Health Instructions & Client Check List - Phone Version Attachment 83 -- MPC Home Health Instructions & Client Check List - Phone Version.doc 08/24/2009
Attachment 82 -- MPC Home Health Instructions & Client Check List - FAX Version Attachment 82 -- MPC Home Health Instructions & Client Check List - FAX Version.doc 08/24/2009
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.