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[PHIC] 2025 Assessment of a Novel Funding Approach for Improving Health in Rural Communities
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Rural Carveout Survey AttA- RurC Surv.docx Yes Yes Fillable Fileable
Form and Instruction n/a Rural Carveout Interview - SHD AttG- RurC Intrvw-SHD.docx Yes Yes Fillable Fileable
Form and Instruction n/a Rural Carveout Interview - SORH AttH- RurC Intrvw-SORH.docx Yes Yes Fillable Fileable

Health Health Care Services

 

144 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 144 0 144 0 0 0
Annual IC Time Burden (Hours) 144 0 144 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Rural Carveout Survey (Screenshots) AttB- RurC Surv_scr.docx 06/16/2025
Survey Pre-Notification Email AttC- RurC Surv PreEm.docx 06/16/2025
Survey Notification Email AttD- RurC Surv NotEm.docx 06/16/2025
Survey Reminder Email AttE- RurC Surv RemEm.docx 06/16/2025
Survey Final Reminder Email AttF- RurC Surv FinEm.docx 06/16/2025
Interview Pre-Notification Email AttI- RurC Intrvw PreEm.docx 06/16/2025
Interview Recruitment Email AttJ- RurC Intrvw RecEm.docx 06/16/2025
Interview Reminder Email AttK- RurC Intrvw RemEm.docx 06/16/2025
Interview Follow-up Email AttL- RurC Intrvw FolEm.docx 06/16/2025
Research Determination AttM- RurC PD.pdf 06/16/2025
SSA SSA STLT 06032025 RurC.docx 06/16/2025
SSB SSB STLT 06032025 RurC_final.docx 06/16/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.