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Federal forms, ICRs, and supporting documents

Information Collection

Survey of past participants of the National Institute of Neurological Disorders and Stroke (NINDS) Anticonvulsant Screening Program (ASP)

IC 213576 under ICR 201307-0925-006 · OMB 0925-0678.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Survey of past participants of the National Institute of Neurological Disorders and Stroke (NINDS) Anticonvulsant Screening Program (ASP)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 ASP Survey Screenshot ASPparticipantsurvey_screenshots2.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

142 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 142 0 142 0 0 0
Annual IC Time Burden (Hours) 36 0 36 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
ASP Fast-Track Template fast-track-template-short-form_ASP.docx 10/22/2014
ASP email ASP survey_email and other text2.docx 10/22/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.