Great Lakes Medical and Allied Health Care Providers Pre-test

Fetal Alcohol Spectrum Disorders Regional Training Centers

OMB: 0920-0954

IC ID: 204240

Information Collection (IC) Details

View Information Collection (IC)

Great Lakes Medical and Allied Health Care Providers Pre-test
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Foundations Online Pre-test E1a_screenshots Great Lakes FASD RTC QUALTRICS Foundatio_pre.pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

450 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 450 0 450 0 0 0
Annual IC Time Burden (Hours) 38 0 38 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Foundations online pre-test - Word E1_Great Lakes FASD RTC Foundations of FASD Pre.docx 09/13/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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