Information Collection

Intervention to Increase Colorectal Cancer Screening in Primary Care Clinics-Clinic Support Staff

IC 182544 under ICR 200909-0920-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Attachment 4c Clinic Support Staff Post-Intervention Survey.doc Instruction
Attachment 5 Post Clinic Support Staff Cover Letter.doc Cover Letter IC Document
Attachment 6 Reminder Postcard Clinic Staff.doc Postcard Reminder IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Intervention to Increase Colorectal Cancer Screening in Primary Care Clinics-Clinic Support Staff	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Attachment 4c Clinic Support Staff 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: 140	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	140	140
Annual IC Time Burden (Hours)	58	58
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Cover Letter	Attachment 5 Post Clinic Support Staff Cover Letter.doc	10/03/2007
Postcard Reminder	Attachment 6 Reminder Postcard Clinic Staff.doc	10/03/2007

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