Sickle Cell Disease Treatment Demonstration Program (SCDTDP) Utilization Questionnaire (pre-demonstration)

Sickle Cell Disease Program Evaluations

OMB: 0915-0344

IC ID: 197489

Information Collection (IC) Details

View Information Collection (IC)

Sickle Cell Disease Treatment Demonstration Program (SCDTDP) Utilization Questionnaire (pre-demonstration)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction EDITED 8-29-11 Attach_E_Individual Utilization Form_March 2010 EDITED 8-29-11 Individual Utilization Data Form_Mar2010 - EDITED 8-29-111-1.pdf Yes No Printable Only

Health Health Care Services

 

900 0
   
Individuals or Households
 
   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 900 0 0 900 0 0
Annual IC Time Burden (Hours) 675 0 0 675 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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