OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Intervention to Increase Colorectal Cancer Screening-Post Intervention

IC 182543 under ICR 200910-0920-011 · OMB 0920-0769.

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

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Intervention to Increase Colorectal Cancer Screening-Post Intervention
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Patient Post-intervention Survey Attachment_4b_Revised_Patient_Post-Intervention_Survey.doc Yes No Printable Only

Health Illness Prevention

42 U.S.C 241   71 FR 52334

2,335 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 2,335 0 0 0 0 2,335
Annual IC Time Burden (Hours) 778 0 0 0 0 778
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Patient Post-intervention Cover Letter Attachment_5_Revised_Post_Patient_Survey_Cover_letter.doc 10/15/2009
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.