Information Collection Request
[NCCDPHP] Community Health Workers for COVID Response and Resilient Communities’ National Evaluation
ICR 202306-0920-005 · OMB 0920-1411 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Community Health Workers CHW Survey |
Form and Instruction | New | Repair queued |
| Community Health Workers Recipient Survey |
Form and Instruction | New | Missing upstream |
 Att 7a - CHW Survey human subjects document exemption determination.pdf |
Supplementary Document | Uploaded 2023-06-09 | Repair queued |
 Att 7 - CCR Recipient Survey human subjects document exemption determination.docx |
Supplementary Document | Uploaded 2023-06-09 | Repair queued |
| Att 6 - 60-day Federal Register Notice.pdf |
Supplementary Document | Uploaded 2023-06-09 | Repair queued |
| Att 5c - CHW Survey Reminder Email .docx |
Supplementary Document | Uploaded 2023-06-09 | Repair queued |
| Att 5b - CHW Survey Introductory Email .docx |
Supplementary Document | Uploaded 2023-06-09 | Repair queued |
| Att 4d - CCR Recipient Survey Reminder.docx |
Supplementary Document | Uploaded 2023-06-09 | Repair queued |
| Att 4c - CCR Recipient Survey Introductory Email.docx |
Supplementary Document | Uploaded 2023-06-09 | Repair queued |
| Att 4b- CCR Evaluation Surveys Announcement Email.docx |
Supplementary Document | Uploaded 2023-06-09 | Repair queued |
| Att 3 - CCR National Evaluation Question Matrix.docx |
Supplementary Document | Uploaded 2023-06-09 | Repair queued |
| Att 2 - DP21-2109 Logic Model.pdf |
Supplementary Document | Uploaded 2023-06-09 | Repair queued |
| Att 1 Authorizing Legislation.pdf |
Supplementary Document | Uploaded 2023-06-09 | Repair queued |
| 0920-23AH CHW_SS Part B.docx |
Supporting Statement B | Uploaded 2023-06-08 | Repair queued |
| 0920-23AH CHW_SS Part A_final.docx |
Supporting Statement A | Uploaded 2023-06-08 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 260599 |  Community Health Workers CHW Survey |
Form and Instruction | New | |
| 260598 | Community Health Workers Recipient Survey |
Form and Instruction | New |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1411 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Agency Tracking No | 0920-23AH |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |