PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Client Interview Protocol
New
120
60
0
Form and Instruction
2
Attachment B2 - Client_Interview_Protocols.docx
Medical Record Abstraction
New
1500
120
0
Form and Instruction
3
Attachment C1 - Medical_Record_Abstraction_long.xlsm
Form and Instruction
4
Attachment C2 - Medical_Record_Astraction_short.xlsm
Provider Interview Protocol
New
100
100
0
Form and Instruction
1
B1 Provder Interview Protocols
Telephone Screening
New
45
12
0
Form and Instruction
5
Attachment D - Telephone_Screener.docx
Total burden requested under this ICR:
1765
292
0
To view an IC, click on IC Title
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