Services Delivery Tracking

Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence Diagnosis and Intervention Project

OMB: 0930-0312

IC ID: 193179

Information Collection (IC) Details

View Information Collection (IC)

Services Delivery Tracking
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form E - DxInt.Service Tracking Form E - DxInt.Service Tracking E- DxInt.Service Tracking.doc Yes Yes Paper Only

Health Public Health Monitoring

 

800 0
   
State, Local, and Tribal Governments
 
   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 9,600 0 9,600 0 0 0
Annual IC Time Burden (Hours) 768 0 768 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Consent Forms Consent forms.pdf 05/27/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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