Document

Attachment I: Facility Data Collection Questionnaire

ICR 201412-0920-013 · OMB 0920-0278 · Object 52434701.

This document may belong to an older filing. More recent activity for OMB 0920-0278:

Document Viewer [doc]

Status: The document is viewable, but some background extraction is still pending.

Queue: Repair is in progress, but the document is still incomplete and remains in the worker queue. (priority 70 · next 2026-04-25 04:57:07)

Missing: html

Download: Source copy (doc)

Primary: htmlSource: application/msword

Loading document viewer…

Document Metadata

File Type	application/msword
File Title	Attachment I: Facility Data Collection Questionnaire
Author	Christine Caffrey
Last Modified By	Moien, Mary (CDC/OSELS/NCHS)
File Modified	2012-03-22
File Created	2012-03-22
Conversion State	partial