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Formative Research for Sepsis and Antibiotic Use Campaigns 17NZ
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Other-Focus Group Guide Yes No Paper Only
Other-Focus Group Guide Yes No Paper Only
Other-Focus Group Guide Yes No Paper Only
Other-Focus Group Guide Yes No Paper Only

Health Illness Prevention

 

750 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 750 0 750 0 0 0
Annual IC Time Burden (Hours) 208 0 208 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request for Approval 02/07/2017
Supporting Statement A 02/07/2017
Supporting Statement B 02/07/2017
Antibiotic Use Consent 02/07/2017
Antibiotic Use Confidentiality 02/07/2017
Sepsis Consent 02/07/2017
Sepsis Confidentiality 02/07/2017
Antibiotic Use IRB Letter 02/07/2017
Sepsis IRB Letter 02/07/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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