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Asthma Management Supplement
NCHS Questionnaire Design Research Laboratory
OMB: 0920-0222
IC ID: 198749
OMB.report
HHS/CDC
OMB 0920-0222
ICR 201002-0920-006
IC 198749
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:
2022-12-21 - Revision of a currently approved collection
2021-08-16 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Asthma Management Supplement
Form
2012 Asthma Supplement
0920-0222 QDRL Asthma Attach 1.pdf
Form
0920-0222 QDRL Asthma Attach 2.docx
Flyer
IC Document
0920-0222 QDRL Asthma Attach 3.docx
Invitation Letter
IC Document
0920-0222 QDRL Asthma 10-day letter.doc
Supporting 10-Day Letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Asthma Management Supplement
Agency IC Tracking Number:
IC Status:
New
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
2012 Asthma Supplement
0920-0222 QDRL Asthma Attach 1.pdf
Yes
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population
FR Citation:
49 FR 37693
Number of Respondents:
40
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
40
0
0
0
0
0
Annual IC Time Burden (Hours)
40
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Flyer
0920-0222 QDRL Asthma Attach 2.docx
08/03/2011
Invitation Letter
0920-0222 QDRL Asthma Attach 3.docx
08/03/2011
Supporting 10-Day Letter
0920-0222 QDRL Asthma 10-day letter.doc
08/04/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.