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

View Information Collection (IC)

Assessment of Local Health Departments' Interventions to Address TB among Persons Experiencing Homelessness
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form None Health Department Homeless TB Data Collection Instrument ATTACHMENT B TB Homeless Instrument- Word v81313.docx Yes Yes Fillable Fileable
Form None Health Department Homeless TB Data Collection Instrument--Screenshots ATTACHMENT C TB Homeless Instrument-Web.docx Yes Yes Fillable Fileable

Health Immunization Management

 

220 0
   
State, Local, and Tribal Governments
 
   100 %

  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 220 0 0 0 0 0
Annual IC Time Burden (Hours) 73 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
ATTACHMENT A TB Homeless Council Recommendations v81313 ATTACHMENT A TB Homeless Council Recommendations v81313.docx 09/05/2013
ATTACHMENT D County state homeless 2009-2011 ATTACHMENT D County state homeless 2009-2011.xlsx 09/05/2013
ATTACHMENT E Advance Notification Email ATTACHMENT E Advance Notification Email.docx 09/05/2013
ATTACHMENT F Notification Email ATTACHMENT F Notification Email.docx 09/05/2013
ATTACHMENT G Reminder Email ATTACHMENT G Reminder Email.docx 09/05/2013
Supporting Statement A_amended 9_5_13_TB among homeless Supporting Statement A_amended 9_5_13_TB among homeless.docx 09/05/2013
Supporting Statement B_TB homeless Supporting Statement B_TB homeless.docx 09/05/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.