EHPI-PALS Facility Survey

Early Hearing Detection and Intervention - Pediatric Audiology Links to Service (EHDI-PALS) Facility Survey

OMB: 0920-0955

IC ID: 205423

Documents and Forms
Document Name
Document Type
Other-SCREENSHOT
Information Collection (IC) Details

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EHPI-PALS Facility Survey
 
No New
 
Voluntary
 
42 CFR 241 42 CFR 280f  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-SCREENSHOT Att D _facility_survey_screen_shots.docx Yes Yes Fillable Printable

Health Health Care Services

 

1,500 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 1,500 0 1,500 0 0 0
Annual IC Time Burden (Hours) 225 0 225 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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