OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Group Intervention Sereening Questionnaire

IC 207858 under ICR 201307-0990-006 · OMB 0990-0414.

Documents and Forms
Document Name
Document Type
Other-survey
Other-Consent
Other-ScreenShot
Information Collection (IC) Details

View Information Collection (IC)

Group Intervention Sereening Questionnaire
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Consent 4B_Group Intervention consent form_13243_28june2013.doc No   Printable Only
Other-ScreenShot WHAM Screening Instrument Screen Shots.docx No   Printable Only
Other-survey 19144_ID (WHAM) Women's Health and Mindfulness Program- Group Intervention Screening Questionnaire.docx No No Printable Only

Health Illness Prevention

 

120 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 120 0 120 0 0 0
Annual IC Time Burden (Hours) 20 0 20 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.