Primary Care Provider Interview Guide

Assessing Problem Areas in Referrals for Chronic Hematologic Malignancies and Developing Interventions to Address Them

OMB: 0920-0836

IC ID: 191095

Documents and Forms
Document Name
Document Type
Other-WORD
Information Collection (IC) Details

View Information Collection (IC)

Primary Care Provider Interview Guide
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Att 12_ PCP Interview Guide 092309.doc Yes Yes Fillable Printable

Health Health Care Services

09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

18 0
   
Private Sector 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 18 0 0 0 0 18
Annual IC Time Burden (Hours) 27 0 0 0 0 27
Annual IC Cost Burden (Dollars) 0 0 -1,789 0 0 1,789

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