Information Collection

Medical Testing

IC 210761 under ICR 201403-0920-006 · OMB 0920-1024.

Documents and Forms

Document Name Document Type
Att N_Medical Testing.docx Other-WORD
Att G_Results letter for Lung tests.docx Att G_Results letter for Lung tests IC Document
Att H Results letter for Blood tests.docx Att H Results letter for Blood tests IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medical Testing	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			Att N_Medical Testing.docx		No	No	Printable Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title: 09-20-0147 Occupational Health Epidemiological Studies and EEOICPA Program Records and WTC Health Program Records, HHS/CDC/NIOSH	FR Citation: 76 FR 34706

Number of Respondents: 95	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	95	95
Annual IC Time Burden (Hours)	158	158
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att G_Results letter for Lung tests	Att G_Results letter for Lung tests.docx	03/11/2014
Att H Results letter for Blood tests	Att H Results letter for Blood tests.docx	03/11/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.