Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Providing Patient Lists for Medical Monitoring Project Patient Sampling Modified 1030 515 0 Instruction
Approaching Sampled Patients for Enrollment Modified 3120 260 0 Instruction
Instruction
Facility Staff Medical Record Abstraction Modified 7520 376 0 Instruction
Instruction
Instruction
Instruction
Facility staff Providing Estimated Patient Loads Modified 936 1872 0 Instruction
Patient Short interview Modified 301 100 0 Form and Instruction 2b 2012 Short Interview Questionnaire for Medical Monitoring Project (MMP)
Patients Standard Interview Modified 7219 5414 0 Form 2a 2012 Standard Interview Questionnaire for Medical Monitoring Project (MMP)
Total burden requested under this ICR: 20126 8537 0  
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