Online Survey Instrument

CDC Model Performance Evaluation Program (MPEP) for Mycobacterium tuberculosis and Nontuberculous Mycobacteria Drug Susceptibility Testing

OMB: 0920-0600

IC ID: 192388

Documents and Forms
Information Collection (IC) Details

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Online Survey Instrument
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none Attachment H: Screen Shots of Survey Instrument Att H Survey Instrument-Web shots.docx Yes Yes Fillable Fileable

Health Health Care Services

 

93 0
   
State, Local, and Tribal Governments
 
   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 186 0 120 0 0 66
Annual IC Time Burden (Hours) 47 0 14 0 0 33
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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