Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Clinical Follow-up Certification Modified 90 90 0 Instruction
Clinical Follow-up Interview Modified 1500 1500 0 Instruction
Household Screening Modified 191100 15861 0 Form and Instruction Attachment H Attachment H
Interview Modified 67500 67500 0 Form and Instruction Attachment B Attachment B
Interview Verification Modified 10125 678 0 Instruction
Screening Verification Modified 5400 362 0 Instruction
Total burden requested under this ICR: 275715 85991 0  
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