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View Information Collection (IC)

View Information Collection (IC)

30-month Follow-up Survey for Z-CAN patients who did not complete the 18-month Follow-up Survey
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Yes Yes Fillable Fileable
Other-Word version of survey content for reference/editing (English and Spanish) No   Paper Only

Disaster Management Emergency Response

09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems   57 FR 62812

220 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 220 0 0 0 0 220
Annual IC Time Burden (Hours) 37 0 0 0 0 37
Annual IC Cost Burden (Dollars) 266 0 0 0 0 266

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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