Evaluation of an Intervention to Increase Colorectal Cancer Screenig in Primary Care Clinics - Clincians

Evaluation of an Intervention to Increase Colorectal Cancer Screening in Primary Care Clinics

Documents and Forms

Document Name Document Type
Evaluation of an Intervention to Increase Colorectal Cancer Screenig in Primary Care Clinics - Clincians Form
Clinician Post-intervention Survey Attachment_4d_Revised_Clinician_Post-Intervention_Survey.doc Form
Attachment_5_Revised_Post_Clinician_Survey_Cover_Letter.doc Clinician Post-intervention Cover Letter IC Document
Attachment_6_Revised_Reminder_Postcard_Clinicians.doc Clinician Post-intervention Reminder Postcard IC Document

Information Collection (IC) Details

IC Title:	Evaluation of an Intervention to Increase Colorectal Cancer Screenig in Primary Care Clinics - Clincians	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
Form	none	Clinician Post-intervention Survey	Attachment_4d_Revised_Clinician_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 %

	Approved	Previously Approved
Annual Number of Responses for this IC	140	140
Annual IC Time Burden (Hours)	70	70
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Clinician Post-intervention Cover Letter	Attachment_5_Revised_Post_Clinician_Survey_Cover_Letter.doc	10/15/2009
Clinician Post-intervention Reminder Postcard	Attachment_6_Revised_Reminder_Postcard_Clinicians.doc	10/15/2009

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