Attachment 2a. Colorectal Cancer Clinical Data Elements for FOBT Programs

Colorectal Cancer Screening Demonstration Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0745 can be found here:

Documents and Forms

Document Name Document Type
Attachment 2a. Colorectal Cancer Clinical Data Elements for FOBT Programs Form
Colorectal Cancer Clinical Data Elements 0920-05CJ ATTACHMENT 2a CCDE Data Definition Table v100-20060206.doc Form
0920-05CJ ATTACHMENT 2b CRCSDP Data Users Manual (v101).pdf CRCDSP Data User's Manual IC Document

Information Collection (IC) Details

IC Title:	Attachment 2a. Colorectal Cancer Clinical Data Elements for FOBT Programs	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	None	Colorectal Cancer Clinical Data Elements	0920-05CJ ATTACHMENT 2a CCDE Data Definition Table v100-20060206.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	750	750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
CRCDSP Data User's Manual	0920-05CJ ATTACHMENT 2b CRCSDP Data Users Manual (v101).pdf

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