Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
18-month Follow-up Survey for Z-CAN patients New 960 112 812 Form and Instruction n/a
Other-Word version of survey content for reference/editing (English and Spanish)
30-month Follow-up Survey for Z-CAN patients who completed the 18-month Follow-up Survey New 660 110 797 Form and Instruction n/a
Other-Word version of survey content for reference/editing (English and Spanish)
30-month Follow-up Survey for Z-CAN patients who did not complete the 18-month Follow-up Survey New 220 37 266 Form and Instruction n/a
Other-Word version of survey content for reference/editing (English and Spanish)
Total burden requested under this ICR: 1840 259 1875  
To view an IC, click on IC Title