Key Informant Interview Invitation Phone Call

Promotion of the National Amyotrophic Lateral Sclerosis (ALS) Registry to Non-referral Centers

Documents and Forms

Document Name Document Type
AppndxP Key Informnt Intervw Invtn Phone Call Chcklst.doc Instruction

Information Collection (IC) Details

IC Title:	Key Informant Interview Invitation Phone Call	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			AppndxP Key Informnt Intervw Invtn Phone Call Chcklst.doc	NA	Yes	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 64	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	64	64
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.