Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys

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

OMB: 0906-0084

IC ID: 264360

Information Collection (IC) Details

View Information Collection (IC)

Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 Attachment A_Individualized Targeted TA Check in Attachment A_Individualized Targeted TA Check in.docx Yes Yes Fillable Fileable
Form 2 Attachment B_Individualized Targeted TA Closeout Attachment B_Individualized Targeted TA Closeout.docx Yes Yes Fillable Fileable
Form 3 Attachment C_Project Officer Survey Attachment C_Project Officer Survey.docx Yes Yes Fillable Fileable
Form 4 Attachment D_Webinar Survey Attachment D_Webinar Survey.docx Yes Yes Fillable Fileable
Form 5 Attachment E_Community of Practice Survey Attachment E_Community of Practice Survey.docx Yes Yes Fillable Fileable
Form 6 Attachment F_Leadership Academy Session Survey Attachment F_Leadership Academy Session Survey.docx Yes Yes Fillable Fileable
Form 7 Attachment G_Leadership Academy Completion Survey Attachment G_Leadership Academy Completion Survey.docx Yes Yes Fillable Fileable
Form 8 Attachment H_Quarterly Overall TA Survey Attachment H_Quarterly Overall TA Survey.docx Yes Yes Fillable Fileable
Form 9 Attachment I_CQI Practicum Check in Survey Attachment I_CQI Practicum Check in Survey.docx Yes Yes Fillable Fileable
Form 10 CQI Practicum Completion Survey Attachment J_CQI Practicum Completion Survey.docx Yes Yes Fillable Fileable

Health Health Care Services

 

2,230 0
   
Individuals or Households
 
   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 2,230 0 2,230 0 0 0
Annual IC Time Burden (Hours) 209 0 209 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Original Generic IC request Supporting Statement DHVECS MIECHV TARC Satisfaction Surveys.docx 01/09/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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