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

View Information Collection (IC)

GenIC #47 - Health Home Core Sets CMCS
 
New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HHQM1 Yes Yes Fillable Fileable
Form HHQM2 Yes Yes Fillable Fileable
Form HHQM3 Yes Yes Fillable Fileable
Form HHQM4 Yes Yes Fillable Fileable
Form HHQM5 Yes Yes Fillable Fileable
Form HHQM6 Yes Yes Fillable Fileable
Form HHQM7 Yes Yes Fillable Fileable
Form HHQM8 Yes Yes Fillable Fileable
Form HHQM9 Yes Yes Fillable Fileable
Form HHQM10 Yes Yes Fillable Fileable
Form HHQM11 Yes Yes Fillable Fileable
Form HHQM12 Yes Yes Fillable Fileable
Form HHQM13 Yes Yes Fillable Fileable
Form HHQM14 Yes Yes Fillable Fileable
Form HHQM15 Yes Yes Fillable Fileable
Form HHQM16 Yes Yes Fillable Fileable
Form HHQM17 Yes Yes Fillable Fileable
Form HHQM18 Yes Yes Fillable Fileable
Form HHQM19 Yes Yes Fillable Fileable
Form HHQM20 Yes Yes Fillable Fileable
Form HHQM21 Yes Yes Fillable Fileable

Health Health Care Services

 

30 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 30 0 30 0 0 0
Annual IC Time Burden (Hours) 1,200 0 1,200 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Supporting Statement 04/12/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.