Jackson Heart Study Physicians

The Jackson Heart Study: Annual Follow-up with Third Party Respondents

OMB: 0925-0491

IC ID: 192849

Information Collection (IC) Details

View Information Collection (IC)

Jackson Heart Study Physicians
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 Physician Questionnniare Attach 11-Physician Questionnaire (PHQ) Form.doc Yes Yes Paper Only
Form 2 Coroner-Medical Examiner Attach 12 -Coroner-Medical Examiner (COR) Form.doc Yes Yes Paper Only

Health Public Health Monitoring

 

200 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested 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 200 0 0 200 0 0
Annual IC Time Burden (Hours) 50 0 0 50 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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