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Information collection

Public Burden Statement: HRSA’s Federal Office of Rural Health Policy (FORHP) will obtain feedback from users of that was recently funded through the CARES Act (P.L. 116-136, P.L. 88-426, 5 U.S.C. 101, 42 U.S.C. Section 210), as amended. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

The OMB control number for this information collection is 0915-0212 and it is valid until 04/30/2024. This information collection is voluntary. Public reporting burden for this collection of information is estimated to average .007 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or

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U.S. Department of Health and Human Services website disclaimers

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