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Adverse Health Effects Associated with Synthetic Cannabinoid Use - Mississippi, 2015

IC 216276 under ICR 201502-0920-018 · OMB 0920-1011.

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Adverse Health Effects Associated with Synthetic Cannabinoid Use - Mississippi, 2015 0920-1011
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form None Synthetic Cannabinoid Use - Medical Records Abstraction Form Appendix1_medical abstraction form.docx None No   Paper Only
Form None Synthetic Cannabinoid Use - Patient (or Surrogate) Interview Appendix2_Patient Interview Questionnaire.docx None No   Paper Only

Health Illness Prevention

Epidemic Investigation Case Records  51 FR 4246

430 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 430 0 430 0 0 0
Annual IC Time Burden (Hours) 426 0 426 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request for GenIC Approval 0920-1011 Marijuana_MS.docx 04/24/2015
MS Epi-Aid Request - LOI MS_Epi AID Request 4 23 15.pdf 04/24/2015
Urgent GenIC Request - email w/ Burden Table FW URGENT 0920-1011 GenIC Request 2015007-XXX Marijuana_MS.msg 04/24/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.