Cycle 3 Qx for Health Information National Trends Survey 4 (HINTS4)

Health Information National Trends Survey 4 (HINTS 4) (NCI)

OMB: 0925-0538

IC ID: 181323

Information Collection (IC) Details

View Information Collection (IC)

Cycle 3 Qx for Health Information National Trends Survey 4 (HINTS4)
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3 Cycle 3 Instrument - English Appendix C - English Instrument.pdf No No Printable Only
Form and Instruction 4 Cycle 3 Instrument - Spanish Appendix D - Spanish Instrument.pdf No No Printable Only

Health Consumer Health and Safety

SORN #09-25-0156, "Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD,"  67 FR 60743

3,500 0
   
Federal Government
 
   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 3,500 0 0 0 0 3,500
Annual IC Time Burden (Hours) 1,750 0 0 0 0 1,750
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Appendix K - Cover Letters in English Appendix K - Cover Letters in English.docx 06/27/2011
Appendix L - Letters in Spanish Appendix L - Letters in Spanish.docx 06/27/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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