OMB control number

Promoting Telehealth for Low-Income Consumers; COVID-19 Telehealth Program

OMB 3060-1271 · FCC.

OMB 3060-1271

This information collection extends the existing requirements for both the Connected Care Pilot Program and the COVID-19 Telehealth Program.

The latest form for Promoting Telehealth for Low-Income Consumers; COVID-19 Telehealth Program expires 2028-08-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form FCC Form 460 Federal Government Form
Business or other for-profit Form
3060-1271 - SS _May final version.docx Supporting Statement A
Federal Government Form
State, Local or Tribal Governments Other-COVID-19, Telehealth Program, LOA
Business or other for-profit Form

All Historical Document Collections

202504-3060-005	Revision of a currently approved collection	2025-05-29
202206-3060-014 Approved without change	Revision of a currently approved collection	2022-06-23
202102-3060-006 Approved without change	No material or nonsubstantive change to a currently approved collection	2021-02-04
202012-3060-017 Approved without change	No material or nonsubstantive change to a currently approved collection	2020-12-31
202012-3060-011 Approved without change	No material or nonsubstantive change to a currently approved collection	2020-12-28
202008-3060-005 Approved without change	Revision of a currently approved collection	2020-08-27
202004-3060-010 Approved with change	New collection (Request for a new OMB Control Number)	2020-04-03

OMB Details

Federal Enterprise Architecture: Health - Health Care Services

Form N/A	Post-Commitment Request Form	Fillable Fileable Signable	Form
Form N/A	COVID-19 Telehealth Request for Reimbursement Form	Fillable Fileable Signable	Form
Form N/A	COVID-19 Telehealth Program Application Form	Fillable Fileable Signable	Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.