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Federal forms, ICRs, and supporting documents

Information Collection

Six and Twelve Month Follow-up Questionnaire - for Children With Asthma

IC 198573 under ICR 201408-0920-008 · OMB 0920-0906.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

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Six and Twelve Month Follow-up Questionnaire - for Children With Asthma
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0906 Appndx D8_6_12mo_FU_Env 7-1-2011 Appndx D9_6_12mo_C7-12 7-1-2011.doc Yes Yes Fillable Fileable

Health Immunization Management

Epidemiological Studies and Surveillance of Disease Problems 09-20-0136  57 FR 62812

832 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 1,664 0 0 0 0 1,664
Annual IC Time Burden (Hours) 277 0 0 0 0 277
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
6 and 12 month - environment - Chinese 6 & 12-mo Follow-up (Environment) Chinese version - November 30, 2011.doc 12/14/2011
6 and 12 month - environment - Spanish 6 & 12-mo Follow-up (Environment) SPANISH - November 30, 2011.doc 12/14/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.