CHIS Cancer Control Module 2011 for Adolescents (CHIS-CCM)

California Health Interview Survey Cancer Control Module (CHIS-CCM) 2011 (NCI)

OMB: 0925-0598

IC ID: 187239

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

CHIS Cancer Control Module 2011 for Adolescents (CHIS-CCM)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 CHIS-CCM 2011 Attach 1 CHIS2011-CCM_1-10-2011_v 6.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

SORN No. 09-25-0200 "Clinical, Basic and Population-based Research Studies of the National Institutes of Health (NIH), HHS/NIH/OD"  67 FR 60776

1,106 0
   
Individuals or Households
 
   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 2,008 0 0 0 0 2,008
Annual IC Time Burden (Hours) 67 0 0 0 0 67
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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