CDC Oral Health Management Information System - MOLAR MIS

CDC Oral Health Management Information System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0739 can be found here:

Documents and Forms

Document Name Document Type
CDC Oral Health Management Information System - MOLAR MIS Form
MOLAR MIS Attachment 3. MOLAR MIS screen shots.pdf Form

Information Collection (IC) Details

IC Title:	CDC Oral Health Management Information System - MOLAR MIS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	MOLAR MIS	Attachment 3. MOLAR MIS screen shots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	20	-22	42
Annual IC Time Burden (Hours)	220	-242	462
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.