PRA Questions for CEN Groups

Questionnaire and Data Collection Testing, Evaluation, and Research for the Health Resources and Services Administration (HRSA)

Documents and Forms

Document Name Document Type
PRA Questions for CEN Groups.docx Instruction
PRA Questions for CEN Groups.docx Instruction
BPHC Fast Track Memo FINAL.docx Fast Track Memo IC Document
BPHC Fast Track Memo FINAL.docx Fast Track Memo IC Document

Information Collection (IC) Details

IC Title:	PRA Questions for CEN Groups	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
Instruction			PRA Questions for CEN Groups.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	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	80	80
Annual IC Time Burden (Hours)	320	320
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Memo	BPHC Fast Track Memo FINAL.docx	06/29/2023

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