View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Center for Questionnaire Design and Evaluation Research (CQDER) CMS 10-day Letter 16AEE
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Yes Yes Fillable Printable
Form and Instruction 0920-16AEE Yes Yes Fillable Printable
Form and Instruction 0920-16AEE Yes Yes Fillable Printable
Form and Instruction 0920-16AEE Yes Yes Fillable Printable

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probability Samples of the U. S. Population 09-20-0164   49 FR 37693

100 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 100 0 100 0 0 0
Annual IC Time Burden (Hours) 50 0 50 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CQDER CMS 10-day Letter 042016 04/26/2016
CQDER CMS Att 4ab Informed Consent 04/26/2016
CQDER CMS Att 6ab Thank You Letter 04/26/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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