Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Interview Questionnaire Modified 7760 5173 134015 Form and Instruction none 2024 Programming Questionnaire - English
Lookup Contact Information Modified 1940 65 1622 Instruction
Model Patient Recruitment Script - Facility Modified 970 81 2027 Form and Instruction none Recruitment script
Pull Medical Records Modified 7760 388 9700 Instruction
Total burden requested under this ICR: 18430 5707 147364  
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