Individuals Screened/Coginitive testing

Facts for Consumers About Health

OMB: 0955-0002

IC ID: 189373

Documents and Forms
Document Name
Document Type
Other-telephone script
Other-testing
Information Collection (IC) Details

View Information Collection (IC)

Individuals Screened/Coginitive testing
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-telephone script Attachment B OMB 0955-0002.docx No No Paper Only
Other-testing Attachment D OMB 0955-0002.docx No No Paper Only

Health Consumer Health and Safety

 

104 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 104 0 20 0 84 0
Annual IC Time Burden (Hours) 26 0 5 0 21 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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