View Information Collection (IC)

View Information Collection (IC)

PATH/Baseline- Adults Household Screener
No Modified

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Household Screener 3a - English. PATH Wave 1 Household Screener 7.5 2013-06-10.pdf Yes Yes Fillable Fileable

Health Immunization Management

NIH Privacy Act System of Records 09-25-0200 Clinical, Basic Population-based research studies of NIH, HHS/NIH/OD  67 FR 60741

104,725 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 104,725 0 0 3,742 0 100,983
Annual IC Time Burden (Hours) 24,436 0 0 -4,176 0 28,612
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
3a 3a. Spanish. PATH Wave 1 Household Screener 7.5 2013-06-10.pdf 06/28/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.