Sickle Cell Disease Treatment Demonstration Program (SCDTDP) Evaluation - Health Survey

Sickle Cell Disease Program Evaluations

OMB: 0915-0344

IC ID: 197491

Information Collection (IC) Details

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Sickle Cell Disease Treatment Demonstration Program (SCDTDP) Evaluation - Health Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 004_Sickle Cell_Adult Health Survey 004_Sickle Cell_Adult Health Survey Attach_Q_SF_36_Adult_HealthSurvey.docx Yes Yes Fillable Fileable

Health Health Care Services

 

630 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 1,260 0 0 1,260 0 0
Annual IC Time Burden (Hours) 315 0 0 315 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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