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Symptom And Disease Prevalence Questionnaire And Supplemental Modules

IC 165771 under ICR 199308-0923-001 · OMB 0923-0012.

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SYMPTOM AND DISEASE PREVALENCE QUESTIONNAIRE AND SUPPLEMENTAL MODULES
 
No Migrated
 
Voluntary
 

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


    

13,500 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 13,500 0 0 0 0 13,500
Annual IC Time Burden (Hours) 5,622 0 18 0 0 5,604
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.