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Chronic Disease Self-Management Education Program
Chronic Disease Self-Management Education Program
OMB: 0985-0036
IC ID: 206270
OMB.report
HHS/ACL
OMB 0985-0036
ICR 201908-0985-003
IC 206270
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0036 can be found here:
2022-12-01 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 5
Chronic Disease Self-Management Education Program
Form and Instruction
5 CDSME Progress Report Instructions
CDSME-Progress-Report-Instructions.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Chronic Disease Self-Management Education Program
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
5
CDSME Progress Report Instructions
CDSME-Progress-Report-Instructions.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
8
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
0
0
0
-16
0
16
Annual IC Time Burden (Hours)
0
0
0
-107
0
107
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.