FOLLOW UP OF TUBERCULOSIS PATIENTS EXPOSED TO MULTIPLE CHEST FLUOROSCOPIES

ICR 199309-0925-003

OMB: 0925-0255

Federal Form Document

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Name
Status
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ICR Details
0925-0255 199309-0925-003
Historical Active 199307-0925-003
HHS/NIH
FOLLOW UP OF TUBERCULOSIS PATIENTS EXPOSED TO MULTIPLE CHEST FLUOROSCOPIES
Revision of a currently approved collection   No
Regular
Approved without change 12/14/1993
Retrieve Notice of Action (NOA) 09/22/1993
  Inventory as of this Action Requested Previously Approved
12/31/1996 12/31/1996 01/31/1994
2,200 0 3,500
367 0 585
0 0 0

FORMER TUBERCULOSIS PATIENTS WHO WERE IRRADIATED DURING THEIR TREATMEN WILL BE ASKED TO RESPOND TO A TELEPHONE QUESTIONNAIRE WHICH ASSESSES INFORMATION ABOUT CANCER AND ITS RISK FACTORS IN ORDER TO ESTIMATE RADIATION RISKS.

None
None


No

1
IC Title Form No. Form Name
FOLLOW UP OF TUBERCULOSIS PATIENTS EXPOSED TO MULTIPLE CHEST FLUOROSCOPIES

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,200 3,500 0 0 -1,300 0
Annual Time Burden (Hours) 367 585 0 0 -218 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/22/1993


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