Physican Response Form

Formative Research on Lung Cancer

OMB: 0920-0801

IC ID: 187253

Documents and Forms
Document Name
Document Type
Other-WORD
Information Collection (IC) Details

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Physican Response Form
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Attachment F Physician Response Form.doc No No Fillable Printable

Health Illness Prevention

 

64 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 64 0 64 0 0 0
Annual IC Time Burden (Hours) 5 0 5 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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