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Health Care Provider Knowledge, Attitudes and Beliefs Questionnaire - Pre-Intervention

IC 183856 under ICR 200802-0920-009 · OMB 0920-0788.

Documents and Forms
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Form and Instruction
Form and Instruction
IC Document
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Health Care Provider Knowledge, Attitudes and Beliefs Questionnaire - Pre-Intervention
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction No number Provider Questionnaire - Pre-intervention Attachment 6b Provider Questionnaire (Knowledge Attitues Beliefs) Pre-intervention.doc Yes No Paper Only

Health Illness Prevention

Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

466 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 466 0 466 0 0 0
Annual IC Time Burden (Hours) 62 0 62 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment 6a Non-physician referral instructions Attachment 6a Non-physician referral instructions.doc 12/19/2007
Attachment 6a Physician Referral Instructions Attachment 6a Physician Referral Instructions.doc 12/19/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.