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Clinic Visit Record For Family Planning Services

IC 165981 under ICR 197910-0937-004 · OMB 0937-0005.

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Information Collection (IC) Details

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CLINIC VISIT RECORD FOR FAMILY PLANNING SERVICES
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form PHS 6138-1 No No
Form THRU 14 No No
Form PHS6138-1 No No
Form PHS6138-14 No No


    

1,800 0
   
Private Sector Businesses or other for-profits
 
   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 320,000 0 0 0 0 320,000
Annual IC Time Burden (Hours) 48,000 0 0 0 0 48,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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