Descriptive Epidemiology of Missed or Delayed Diagnosis for Conditions Detected by Newborn Screening - Case Report Form

Descriptive Epidemiology of Missed or Delayed Diagnosis for Conditions Detected by Newborn Screening

Documents and Forms

Document Name Document Type
Form None assigned Descriptive Epidemiology of Missed or Delayed Diagnosis for Conditions Detected by Newborn Screening - Case Report Form Form and Instruction
None assigned Attachment 6 Case Report Form 0920-0641 Attachment 6 Case Report Form.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Descriptive Epidemiology of Missed or Delayed Diagnosis for Conditions Detected by Newborn Screening - Case Report Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Form and Instruction	None assigned	Attachment 6 Case Report Form	0920-0641 Attachment 6 Case Report Form.doc		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 135	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	135	135
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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