Screening Form

Exploratory Research with People Living with Lung Cancer

OMB: 0920-0813

IC ID: 188700

Documents and Forms
Information Collection (IC) Details

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Screening Form
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 4 Screening Form Att 8 Screening Form.doc No No Paper Only

Health Health Care Services

 

66 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 66 0 66 0 0 0
Annual IC Time Burden (Hours) 11 0 11 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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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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