Information Collection Request

Evaluation of Genomic Applications in Practice and Prevention (EGAPP)

ICR 200703-0920-005 · OMB 0920-0751 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
D5. General Survey Form and Instruction New Available
D4. Policy Survey Form and Instruction New Available
Attachment D3 HealthCare Purchaser Survey Form and Instruction New Available
D. 2 Policy/Payer Survey Form and Instruction New Available
Health Care Provider Survey Form and Instruction New Available
EGAPP Summary.doc Supporting Statement B Uploaded 2007-08-13 Available
ATTACHMENT C Intro Letter.doc Supplementary Document Uploaded 0000-00-00 Available
ATTACHMENT 1 Index of Survey's D 1 thru D5.doc Supplementary Document Uploaded 0000-00-00 Available
60 Day FINAL.pdf Supplementary Document Uploaded 0000-00-00 Available
30 Day FINAL.pdf Supplementary Document Uploaded 0000-00-00 Available
ATTACHMENT B Public Law.doc Supplementary Document Uploaded 0000-00-00 Available
Summmary State EGAPP. 06BI.doc Supporting Statement A Uploaded 0000-00-00 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
179077 (EGAPP) - General Survey - att D5 Form and Instruction NewD5. General Survey
179076 (EGAPP) - Policy Survey - att D4 Form and Instruction NewD4. Policy Survey
179075 (EGAPP) - Purchaser Survey - att D3 Form and Instruction NewAttachment D3 HealthCare Purchaser Survey
179074 (EGAPP) - Policy Payer survey - att D2 Form and Instruction NewD. 2 Policy/Payer Survey
179073 (EGAPP) - Health Care Providers (att D1) Form and Instruction NewHealth Care Provider Survey

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2010 36 Months From Approved
2,691 0 0
443 0 0
0 0 0





Reginfo record details
5
table that charts list of burden
IC Title Form No. Form Name
(EGAPP) - General Survey - att D5 None
(EGAPP) - Health Care Providers (att D1) None
(EGAPP) - Policy Payer survey - att D2 None
(EGAPP) - Policy Survey - att D4 None
(EGAPP) - Purchaser Survey - att D3 None

table that charts list of burden
  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 2,691 0 0 2,691 0 0
Annual Time Burden (Hours) 443 0 0 443 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No