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Form 2 Background Form
National Healthy Start Evaluation and Quality Assurance
B1 - Background Form
Background and Demographic Information Form
OMB: 0915-0338
OMB.report
HHS/HSA
OMB 0915-0338
ICR 202503-0915-001
IC 195559
Form 2 Background Form
( )
Document [docx]
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File Type
application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title
Healthy Start Background Information
Author
Harwood, Robin (HRSA);ADeterman@hrsa.gov;sbarrett@hrsa.gov
File Created
2025:05:19 11:08:10Z
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