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Field Test of SPPC-II Toolkit and Training Modules during Pilot Phase of SPPC-II Demonstration Project
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Yes Yes Fillable Fileable
Form and Instruction 2 Yes Yes Fillable Fileable
Form and Instruction 1 Yes Yes Fillable Fileable
Form and Instruction 2 Yes Yes Fillable Fileable

Health Health Care Services

 

32 0
   
Individuals or Households
 
   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 32 0 32 0 0 0
Annual IC Time Burden (Hours) 17 0 17 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment A -- Healthcare Research and Quality Act of 1999 03/29/2019
Attachment C – Field Test Oral Consent Form – Tier 1 03/29/2019
Attachment D – Field Test Oral Consent Form – Tier 2 03/29/2019
Attachment F – List of Stakeholder Panel Members 03/29/2019
Cover Letter 04/02/2019
Supporting Statement Part A 03/29/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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