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
Form 0920-25-0058
Form 0920-25-0058
Lookup Contact Information Unchanged 1940 65 1622 Instruction
Model Patient Recruitment Script - Facility Unchanged 970 81 2027 Form and Instruction none
Pull Medical Records Unchanged 7760 388 9700 Instruction
Total burden requested under this ICR: 18430 5707 147364  
To view an IC, click on IC Title