Information Collection

CDC/CLSI POC Fingerstick Glucose Testing Survey (FGS 1-3)

IC 217102 under ICR 201506-0920-004 · OMB 0920-1088.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CDC/CLSI POC Fingerstick Glucose Testing Survey (FGS 1-3)	Form and Instruction
CDC/CLSI Point-of-Care Fingerstick Glucose Testing Surve Appendix C Survey_Merged_Screenshots3-27-15.pdf	Form and Instruction
CDC/CLSI Point-of-Care Fingerstick Glucose Testing Surve Appendix D Surveys_2_and_3_Merged_Screenshots3-27-15.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	CDC/CLSI Point-of-Care Fingerstick Glucose Testing Survey (FGS1)	Appendix C Survey_Merged_Screenshots3-27-15.pdf	None	Yes	Yes	Fillable Fileable
Form and Instruction	None	CDC/CLSI Point-of-Care Fingerstick Glucose Testing Survey (FGS2,3)	Appendix D Surveys_2_and_3_Merged_Screenshots3-27-15.pdf	None	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 74,070

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	74,070	74,070
Annual IC Time Burden (Hours)	18,518	18,518
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.