Signed Consent Forms for Medical Exams

Chronic Beryllium Disease Prevention Program

OMB: 1910-5112

IC ID: 45140

Information Collection (IC) Details

View Information Collection (IC)

Signed Consent Forms for Medical Exams
 
No Modified
 
Mandatory
 
10 CFR 850

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction DOE F 440-1 Chronic Beryllium Disease Prevention Program Informed Consent Form DOE F 440-1.pdf Yes No Paper Only

Health Illness Prevention

 

5,780 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 5,930 0 0 4,147 0 1,783
Annual IC Time Burden (Hours) 1,483 0 0 1,037 0 446
Annual IC Cost Burden (Dollars) 143,718 0 0 103,846 0 39,872

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

© 2024 OMB.report | Privacy Policy