2024 Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Evaluation Surveys

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

Documents and Forms

Document Name Document Type
Form 1 2024 Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Evaluation Surveys Form
1 Conference Evaluation Survey Instrument A_Conference Evaluation Survey.docx Form
1 Conference Evaluation Survey Instrument A_Conference Evaluation Survey.docx Form
Fast track memo.ITAC Satisfaction Surveys.docx Original Generic Request IC Document
Fast track memo.ITAC Satisfaction Surveys.docx Original Generic Request IC Document

Information Collection (IC) Details

IC Title:	2024 Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Evaluation Surveys	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Conference Evaluation Survey	Instrument A_Conference Evaluation Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,960	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,960	1,960
Annual IC Time Burden (Hours)	102	102
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Original Generic Request	Fast track memo.ITAC Satisfaction Surveys.docx	01/09/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.