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ealth Center Workforce Survey Evaluation and Technical Assistance: Pilot Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 Survey Survey V9_FINAL (2).docx Yes Yes Fillable Fileable

Health Health Care Services

 

300 0
   
Private Sector Not-for-profit institutions
 
   100 %

  Requested 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 300 0 300 0 0 0
Annual IC Time Burden (Hours) 150 0 150 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A FINAL Survey Supporting Statement A.docx 06/29/2023
Supporting Statement B Final Pilot Survey Supporting Statement B _Update TM_highlighted revisions.docx 06/29/2023
Health Center Workforce Survey Invitation System (Pilot Survey)- Google Form Health Center Workforce Survey Invitation System (Pilot Survey)- Google For.pdf 06/29/2023
Health Center Workforce Survey Invitation System (Pilot Survey) - Screenshot Health Center Workforce Survey Invitation System (Pilot Survey) Screenshot.png 06/29/2023
HRSA Workforce - Pilot II _ SurveyAnalytics Survey Spanish HRSA Workforce - Pilot II _ SurveyAnalytics Survey Spanish.pdf 06/29/2023
English_Spanish HRSA Health Center Workforce Survey and Emails 20220316 English_Spanish HRSA Health Center Workforce Survey and Emails_cl.docx 06/29/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.