eConsent surveys

Comprehensive Communication Campaign for HITECH ACT

OMB: 0955-0005

IC ID: 200902

Information Collection (IC) Details

View Information Collection (IC)

eConsent surveys
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-survey 0990-0376_20111215_eConsent_Survey_v1.docx Yes Yes Fillable Printable

Health Illness Prevention

 

2,800 0
   
Individuals or Households
 
   0 %

  Requested 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 2,800 0 0 0 0 0
Annual IC Time Burden (Hours) 233 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
0990-0376_eConsent surveyMini Supporting Statement Approved Generic 0990-0376_eConsent surveyMini Supporting Statement Approved Generic.docx 12/21/2011
0990-0376_20111215_eConsent_cover_letter_v1 0990-0376_20111215_eConsent_cover_letter_v1.docx 12/21/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

© 2024 OMB.report | Privacy Policy