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

View Information Collection (IC)

Pelvic Health Physical Therapy Surveys 120
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0917-0036-120 PP Low Back Pelvic Girdle Pain Survey Pregnancy Postpartum Low Back Pelvic Girdle Pain Survey edits.docx No   Paper Only
Form and Instruction 0917-0036-120a PP Physical Therapy Survey Pregnancy Postpartum Physical Therapy Survey edits.docx No   Paper Only
Form and Instruction 0917-0036-120b UI Class Survey Urinary Incontinence Class Survey edits.docx No   Paper Only

Health Public Health Monitoring

 

100 0
   
Individuals or Households
 
   0 %

  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) 8 0 8 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement Generic Clearance Submission Template -Pelvic Health Physical Therapy Surveys.docx 10/06/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.