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Federal forms, ICRs, and supporting documents

Information Collection

Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) Healthcare Provider Perspective Interview

IC 229050 under ICR 201503-0920-011 · OMB 0920-1071.

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

View Information Collection (IC)

Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) Healthcare Provider Perspective Interview 0920-1071-18FP
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA MECFS HP - Screener Appendix 1_MECFS HCP Screener_Final_11_14_17.docx NA No   Fillable Printable
Form and Instruction NA MECFS HP - Individual Interview Appendix 2_MECFS HCP Individual Interview Guide_Final_11_14_2017.docx NA No   Fillable Printable
Form and Instruction NA MECFS HP - Dyadic Interview Appendix 3_MECFS HCP Dyadic Interview Guide_Final_11_14_2017.doc NA No   Fillable Printable

Health Public Health Monitoring

 

70 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 70 0 70 0 0 0
Annual IC Time Burden (Hours) 23 0 23 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
IRB Exemption Appendix 4_IRB Exemption.docx 11/15/2017
GenIC Request Generic Clearance MECFS HCP Perspective Form 20NOV2017.docx 11/20/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.