Peds QL Diabetes Module

SEARCH for Diabetes in Youth Study

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0904 can be found here:

Documents and Forms

Document Name Document Type
4b13_Pediatric Diabetes QOL Scale.pdf Other-WORD

Information Collection (IC) Details

IC Title:	Peds QL Diabetes Module	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			4b13_Pediatric Diabetes QOL Scale.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: 09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 710	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	710	710
Annual IC Time Burden (Hours)	59	59
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.