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Public Health in Indian Country Capacity Scan Assessment (PHICCS) 0920-0879-18AZR
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0879 PHICCS Instrument - Web Version Attachment C - PHICCS Instrument (Web version).docx NA Yes Yes Fillable Fileable
Form and Instruction 0920-0879 PHICCS Phone Administration of Instrument - Introduction Attachment E - PHICCS Phone Administration of Instrument_Introductory Language.docx NA No   Fillable Fileable
Form and Instruction 0920-0879 PHICCS Phone Administration of Instrument - Word Version Attachment D - PHICCS Instrument (Word version)_revised.docx NA No   Fillable Fileable

Health Consumer Health and Safety

 

261 0
   
State, Local, and Tribal Governments
 
   65 %

  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 261 0 261 0 0 0
Annual IC Time Burden (Hours) 261 0 261 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Respondent Breakdown Attachment A - Respondent Breakdown.docx 09/07/2018
2010 NIHB Tribal Public Health Profile Attachment B - 2010 NIHB Tribal Public Health Profile.pdf 09/07/2018
ASTHO Profile Attachment F - ASTHO Profile Volume Three.pdf 09/07/2018
NACCHO - 2016 Report Attachment G - NACCHO 2016 Report.pdf 09/07/2018
PHICCS - Email Invitation Attachment I - PHICCS Email Invitation-revised.docx 09/07/2018
PHICCS - Email Reminder Attachment J - PHICCS Email Reminder-revised.docx 09/07/2018
PHICCDS - Phone Reminder Attachment K - PHICCS Phone Reminder-revised.docx 09/07/2018
PHICCS - Pre-Launch Webinar Email Attachment L - PHICCS Pre-Launch Webinar Email.docx 09/07/2018
PHICCS - Pre-Launch Webinar Attachment M - PHICCS Pre-Launch Webinar.docx 09/07/2018
IHS - Email of Support Attachment H - IHS Email of Support.docx 09/07/2018
Supporting Statement A PHICCS-SSA-071318-Revised - IHS Comments - 8-31-2018.docx 09/07/2018
Supporting Statement B PHICCS-SSB-revised.docx 09/07/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.