MMP Provider Survey Web-based Application Screenshots

Attachment 2
MMP Provider Survey
Web-based Application Screenshots

FORM APPROVED
OMB NO.: 0920-0840
EXPIRATION DATE:

Public reporting burden of this collection of information
is estimated to average 30 minutes per response, including
the time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of
information. An agency may not conduct or sponsor, and a
person is not required to respond to a collection of
information unless it displays a currently valid OMB
control number. Send comments regarding this burden
estimate or any other aspect of this collection of
information, including suggestions for reducing this
burden to: CDC, Project Clearance Officer, 1600 Clifton
Road, MS D-24, Atlanta, GA 30333, ATTN: PRA (0920-0840).
Do not send the completed form to this address.