Complaint Forms for Civil Rights and Conscience; Health Information Privacy and Security Complaints

ICR 202209-0945-001

OMB: 0945-0002

Federal Form Document

Forms and Documents

Document Name	Status
Form 0945-0002 Civil Rights and Conscience Complaint Form	Modified
10-31 updated to add annualized cost per PRA officer Final 7-7-22 Supporting document HH.docx Supporting Statement A	2022-10-31

IC Document Collections

IC ID	Document Title	Status
236663	Civil Rights and Conscience Complaint Form	Modified
190142	Health Information Privacy and Security Complaint Other-form	Modified