Refugee Support Services Refugee Health Promotion Set-Aside Programs Assessment Guide

Formative Data Collections for ACF Program Support

Documents and Forms

Document Name Document Type
QUEST_RHP SRHC Interview.docx Other-Interview
QUEST_RHP Client Questionnaire.docx Other-Questionnaire
QUEST_RHP Local Provider Guide.docx Other-Focus Group Protocol
SSA_RSS Set Asides Assessment_Formative Prog Support_RHP_8.20.2024_updated.docx SSA - Refugee Support Services Refugee Health Promotion Set-Aside Programs Assessment Guides IC Document
Letter_RHP Client Invitation and Consent_ENGLISH.docx Consent Form - RSS RHP Set-Aside Programs Assessment Guide IC Document

Information Collection (IC) Details

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents:	Number of Respondents for Small Entity:

Affected Public:

Percentage of Respondents Reporting Electronically:

		Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC
Annual IC Time Burden (Hours)
Annual IC Cost Burden (Dollars)

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.