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Information Collection

Coal Workers' Health Surveillance Program (CWHSP)- Invoice-Pathologist

IC 197447 under ICR 201302-0920-006 · OMB 0920-0020.

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Form
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Coal Workers' Health Surveillance Program (CWHSP)- Invoice-Pathologist
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 5 Coal Workers' Health Surveillance Program (CWHSP)-Consent Release and History Form- Next of Kim (form 2.6) Attmt 9- CDC NIOSH 2.6 NCWAS Consent Release History Form 4.18.11.doc No No Paper Only
Form 6 Coal Workers' Health Surveillance Program (CWHSP)- Invoice-Pathologist Attmt 10- Pathologist Invoice Sample.pdf No No Paper Only

Health Immunization Management

 

50 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 50 0 0 0 0 50
Annual IC Time Burden (Hours) 4 0 0 0 0 4
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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