Initial Participants (Health Questionnaire) Phase 3

Factors Influencing the Transmission of Influenza

OMB: 0920-0888

IC ID: 196088

Information Collection (IC) Details

View Information Collection (IC)

Initial Participants (Health Questionnaire) Phase 3
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Att 4-health questionnaire_Influenza 11 15 10.docx Yes Yes Fillable Printable

Health Illness Prevention

09-20-0147 " Occupational Health Epidemiological Studies and EEOICPA Program Records"  51 FR 226

44 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 0 0 -44 0 0 44
Annual IC Time Burden (Hours) 0 0 -4 0 0 4
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att 3-flyer_Influenza 11 15 10 Att 3-flyer_Influenza 11 15 10.docx 12/20/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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