Illness Checklist

The Green Housing Study

OMB: 0920-0906

IC ID: 198576

Information Collection (IC) Details

View Information Collection (IC)

Illness Checklist
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Illness Checklist Appendix D9 - Illness Checklist (Children 7-12 years) 5-10-11.doc Yes No Paper Only

Health Immunization Management

Epidemiological Studies and Surveillance of Disease Problems 09-20-0136  57 FR 62812

832 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 3,328 0 0 0 0 3,328
Annual IC Time Burden (Hours) 277 0 0 0 0 277
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Illness checklist - Chinese Appendix D9 - Illness Checklist (Children 7-12 years) 5-10-11_CHN7.30.2011.doc 12/14/2011
Illness Checklist - Spanish Appendix D9 - Illness Checklist (Children 7-12 years) 5-10-11 SPANISH.docx 12/14/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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