CCOE Center Director and Program Coordinator Survey

DataCollection for the Identification ofComparisonGroups for the National Com. Ctrs of Excellencein Women's Health (CCOE) Program

Documents and Forms

Document Name Document Type
Round_II_CCOE_Eval_Meth_20061004 (2).doc Other-Other
Round_II_CCOE_CtrDirector_PC_Survey_20061020.doc Other-Other
Round_II_CCOE_Community_Partner_Survey_20061018.doc Other-Other
Round II CCOE Participant Survey_20061004.doc Other-Other
Round II_CCOE_Site_Visit_Protocol_20061020.doc Other-Other

Information Collection (IC) Details

IC Title:	CCOE Center Director and Program Coordinator Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Other	Round_II_CCOE_Eval_Meth_20061004 (2).doc	No	No	Paper Only
Other-Other	Round_II_CCOE_CtrDirector_PC_Survey_20061020.doc	No	No	Paper Only
Other-Other	Round_II_CCOE_Community_Partner_Survey_20061018.doc	Yes	Yes	Paper Only
Other-Other	Round II CCOE Participant Survey_20061004.doc	Yes	Yes	Paper Only
Other-Other	Round II_CCOE_Site_Visit_Protocol_20061020.doc	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	14	-6,196	6,210
Annual IC Time Burden (Hours)	7	-1,704	1,711
Annual IC Cost Burden (Dollars)	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.