Information Collection

Intervention to Increase Colorectal Cancer Screening-Post Intervention

IC 182543 under ICR 200710-0920-011 · OMB 0920-0769.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0769 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 4b Patient Post-Intervention Survey.doc	Instruction
Attachment 5 Post Patient Survey Cover letter.doc Cover Letter	IC Document

IC Title:

Intervention to Increase Colorectal Cancer Screening-Post Intervention

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Attachment 4b Patient Post-Intervention Survey.doc		Yes	No	Printable Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title: 42 U.S.C 241

FR Citation: 71 FR 52334

Number of Respondents: 2,335

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,335	2,335
Annual IC Time Burden (Hours)	778	778
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Cover Letter	Attachment 5 Post Patient Survey Cover letter.doc	10/03/2007

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