OMB control number

Red Carpet Entry (RCE) Program Implementation Project

OMB 0920-1379 · HHS/CDC.

OMB 0920-1379

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920 RCE Report Card Form and Instruction
Form 0920- Screener Form and Instruction
Form 0920 Clinic Leadership Interview Guide Form and Instruction
Form 0920- Staff Interview Guide – Preparation Phase Form and Instruction
Form 0920- Staff Interview Guide– Implementation Phase (months 2,4,6) Form and Instruction
Form 0920- Staff Interview Guide – Implementation Phase (months 1,3,5) Form and Instruction
Form 0920- Staf fSurvey– Implementation Phase [Months 2, 4, 6] Form and Instruction
Form 0920- Staff Survey – Implementation Phase [Months 1, 3, 5] Form and Instruction
Form 0920- Staff Survey – Preparation Phase Form and Instruction
SSB.docx Supporting Statement B
SSA.docx Supporting Statement A
Att 4d HIPAA (Span).docx Supplementary Document
Att 4c HIPAA (Eng).docx Supplementary Document
Att 4b Client Inf Con (Span).docx Supplementary Document
Att 4a Client Inf Con (Eng).docx Supplementary Document
Att 9 PrivacyImpactAssessment_PIA.pdf Supplementary Document
Att 8b Readiness Worksheet.docx Supplementary Document
Att 8a Quick Guide.docx Supplementary Document
Att 8 RCE Impl Manual.docx Supplementary Document
Att 6c Staff Palm Cards.pdf Supplementary Document
Att 6a Social Media Posts.docx Supplementary Document
Att 6b Client Palm Cards.pdf Supplementary Document
Att 5 RTI IRB Decision.pdf Supplementary Document
Att 1 Auth Legislation.docx Supplementary Document
RCE Report Card Form and Instruction
Screener Form and Instruction
Non-Labor Cost Questionnaire Other-EXCEL
Clinic Leadership Interview Guide Form and Instruction
Staff Interview Guide – Preparation Phase Form and Instruction
Staff Interview Guide– Implementation Phase (months 2,4,6) Form and Instruction
Staff Interview Guide – Implementation Phase (months 1,3,5) Form and Instruction
Labor Cost Questionnaire Other-EXCEL
Staf fSurvey– Implementation Phase [Months 2, 4, 6] Form and Instruction
Staff Survey – Implementation Phase [Months 1, 3, 5] Form and Instruction
Staff Survey – Preparation Phase Form and Instruction

All Historical Document Collections

202202-0920-001

Approved without change

New collection (Request for a new OMB Control Number)

2022-03-29