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Federal forms, ICRs, and supporting documents

Information Collection

NIS 2008 Teen Immunization Questionnaire

IC 186085 under ICR 200808-0920-005 · OMB 0920-0214.

Documents and Forms
Document Name
Document Type
Form
Form
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

NIS 2008 Teen Immunization Questionnaire
 
Yes New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CDC 64.122 National Immunization Survey - Teen Attachment4 NIS Teen Questionnaire.pdf Yes No Paper Only
Form and Instruction Not assigned NIS 2008 Teen Immunization Questionnaire Attachment4 NHIS Teen Questionnaire Updated.pdf Yes No Paper Only

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population  49 FR 37693

4,800 0
   
State, Local, and Tribal Governments
 
   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 4,800 0 4,800 0 0 0
Annual IC Time Burden (Hours) 400 0 400 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Cover sheet for NIS Teen Questionnaire Attachment4 Cover.doc 08/07/2008
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.