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Childhood Lead Blood Levels Form
No Modified

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1175 Childhood Lead Blood Levels Form Att4b_ChldhdLdBldLvl_Form_2020.docx NA Yes Yes Fillable Fileable

Health Public Health Monitoring


18 0
State, Local, and Tribal Governments
   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 18 0 0 0 0 18
Annual IC Time Burden (Hours) 1,440 0 0 0 0 1,440
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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