Record Keeping for sterilization consent forms

42 C.F.R. Subpart B: Sterilization of Persons in Federally Assisted Family Planning Projects

OMB: 0937-0166

IC ID: 191181

Information Collection (IC) Details

View Information Collection (IC)

Record Keeping for sterilization consent forms
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 50.Sub Part B

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0937-0166 Sterilization form 0937-0166sterilization consent form OMB 11 2009 approval.doc No No Printable Only

Health Health Care Services

 

100,000 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 100,000 0 0 0 0 100,000
Annual IC Time Burden (Hours) 25,000 0 0 0 0 25,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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