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View Information Collection (IC)

View Information Collection (IC)

Access to Electronic HCR during Outbreak and Assessment of State PHD Immunization Billing Reimbursement Projects 0920-14JS/0920-14TU
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0879 Yes No Fillable Printable
Form and Instruction 0920-0879 Yes No Fillable Printable
Form and Instruction 0920-0879 Yes No Fillable Printable
Form and Instruction 0920-0879 Yes No Fillable Printable
Form and Instruction 0920-0879 Yes No Fillable Printable
Form and Instruction 0920-0879 Yes No Fillable Printable

Health Consumer Health and Safety

 

110 0
   
State, Local, and Tribal Governments
 
   50 %

  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 110 0 110 0 0 0
Annual IC Time Burden (Hours) 61 0 61 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
EHR Supporting_Statement_A_041514 04/18/2014
EHR Supporting_Statement_B_041514 04/18/2014
EHR Attachment D_Intro Email_HAI_Epi 04/18/2014
EHR Attachment E- Invitation Email to HAI-EPI 04/18/2014
EHR Attachment F-Invitation Email to Legal Counsel 04/18/2014
EHR Attachment G- Invitation Email to Informatics Director 04/18/2014
EHR Attachment H- Reminder to HAI-EPI 04/18/2014
EHR Attachment I-Reminder to Legal Counsel 04/18/2014
EHR Attachment J-Reminder to Informatics Director 04/18/2014
IZPHD Supporting Statement A _IZ Funding 04/18/2014
IAPHD Supporting Statement B_IZ Funding 04/18/2014
IZPHD Attachment A_List HD Awardees 04/18/2014
IZPHD Attachment E Introductory Email- Phase 1 04/18/2014
IZPHD Attachment F-Reminder Email- Phase 1 04/18/2014
IZPHD Attachment G -Follow-up Email- Phase 1 04/18/2014
IZPHD Attachment H- Interview Introductory Email- Phase 2 04/18/2014
IZPHD Attachment I- Interview Reminder Email- Phase 2 04/18/2014
IZPHD Attachment J- Interview Follow-up Email- Phase 2 04/18/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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