Adult Targeted Surveillance Survey - screener

Targeted Surveillance and Biometric Studies for Enhanced Evaluation of CTGs

OMB: 0920-0977

IC ID: 203638

Information Collection (IC) Details

View Information Collection (IC)

Adult Targeted Surveillance Survey - screener
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Adult Targeted Surveillance Survey - telephone screener Att 7C_ATSS_PhoneInterview.docx Yes Yes Fillable Fileable
Form none Adult Targeted Surveillance Survey telephone screener- Spanish Att 7C-S_ATSS_PhoneInterview_SP.docx Yes Yes Fillable Fileable

Health Immunization Management

Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

13,749 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 13,749 0 13,749 0 0 0
Annual IC Time Burden (Hours) 458 0 458 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att 7D_ATSS_ItemSources_2013_0718 Att 7D_ATSS_ItemSources_2013_0718.pdf 08/06/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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