Reproductive Medical History

The Hispanic Community Health Study/ Study of Latinos (HCHS/SOL)(NHLBI)

OMB: 0925-0584

IC ID: 211971

Information Collection (IC) Details

View Information Collection (IC)

Reproductive Medical History
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 RME-Repro and Medical History-Eng RME-Repro and Medical Hx-Eng.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

9,000 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 9,000 0 9,000 0 0 0
Annual IC Time Burden (Hours) 1,350 0 1,350 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
RMS-Repro and Medical History-Span RMS-Repro and Medical Hx-Span.pdf 06/23/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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