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Attachment 2a. Colorectal Cancer Clinical Data Elements for FOBT Programs
Colorectal Cancer Screening Program
OMB: 0920-0745
IC ID: 179135
OMB.report
HHS/CDC
OMB 0920-0745
ICR 201004-0920-014
IC 179135
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0745 can be found here:
2013-04-04 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment 2a. Colorectal Cancer Clinical Data Elements for FOBT Programs
Form
Colorectal Cancer Clinical Data Elements
0920-05CJ ATTACHMENT 2a CCDE Data Definition Table v100-20060206.doc
Form
0920-05CJ ATTACHMENT 2b CRCSDP Data Users Manual (v101).pdf
CRCDSP Data User's Manual
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Attachment 2a. Colorectal Cancer Clinical Data Elements for FOBT Programs
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
None
Colorectal Cancer Clinical Data Elements
0920-05CJ ATTACHMENT 2a CCDE Data Definition Table v100-20060206.doc
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
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
0
0
-3,000
0
0
3,000
Annual IC Time Burden (Hours)
0
0
-750
0
0
750
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
CRCDSP Data User's Manual
0920-05CJ ATTACHMENT 2b CRCSDP Data Users Manual (v101).pdf
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.