Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
CDC Worksite Health Scorecard New 200 250 9768 Form and Instruction 0920-1014 Attachment C-3 CDC Worksite Scorecard Cognitive Interview Guide_4.24.2017
CDC Worksite Health Scorecard Cognitive Interview New 32 32 1225 Form and Instruction 0920-1014 Attachment C-3 CDC Worksite Scorecard Cognitive Interview Guide_4.24.2017
CDC Worksite Health Scorecard Pilot Evaluation New 200 17 638 Form and Instruction 0920-1014 Attachment C-4 CDC Worksite Scorecard Pilot Eval Screenshots_4.24.2017
CDC Worksite Health Scorecard- Registration Application Modified 200 7 242 Form and Instruction 0920-1014 Attachment C-1_CDC Worksite Health Scorecard Registration Screenshots_6.26.17
Total burden requested under this ICR: 632 306 11873  
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