State Survey of Endoscopic Capacity

ICR 200304-0920-001

OMB: 0920-0590

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
7052
Migrated
ICR Details
0920-0590 200304-0920-001
Historical Active
HHS/CDC
State Survey of Endoscopic Capacity
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 06/02/2003
Retrieve Notice of Action (NOA) 04/04/2003
  Inventory as of this Action Requested Previously Approved
06/30/2006 06/30/2006
2,945 0 0
688 0 0
0 0 0

CDC proposes to conduct a one-time mail survey administered over 3 years among physicians who perform endoscopic colorectal cancer screening and follow-up examinations to make an assessment of the current state-level capacity to perform these examinations for all appropriate persons in 15 selected states. The results of the state-level analysis will be used to (1) identify deficits in the medical infrastructure regarding colorectal cancer procedures; (2) guide the development of training initiatives and educational programs for health care providers; (3) provide critical baseline information for........

None
None


No

1
IC Title Form No. Form Name
State Survey of Endoscopic Capacity

  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 2,945 0 0 2,945 0 0
Annual Time Burden (Hours) 688 0 0 688 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
Yes Part B of Supporting Statement
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.
04/04/2003


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