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Assessment For The Adoption And Use Of Nutrition In Primary Care: How To Help Patients Improve Their Eating Habits

IC 111744 under ICR 199302-0925-002 · OMB 0925-0400.

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IC Title:	ASSESSMENT FOR THE ADOPTION AND USE OF NUTRITION IN PRIMARY CARE: HOW TO HELP PATIENTS IMPROVE THEIR EATING HABITS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 648	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	648	648
Annual IC Time Burden (Hours)	523	523
Annual IC Cost Burden (Dollars)	0	0

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