Follow-up Interview Guide

Older Adult Safe Mobility Assessment Tool

OMB: 0920-1005

IC ID: 217705

Information Collection (IC) Details

View Information Collection (IC)

Follow-up Interview Guide
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Attachment D2 Follow Up Interviewer Guide_1005 OlderAdult Final.docx Yes Yes Printable Only

Health Illness Prevention

09-20-0160 Records of Subjects in Health Promotion and Education Studies  51 FR 42484

900 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 900 0 0 0 0 900
Annual IC Time Burden (Hours) 150 0 0 0 0 150
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Correspondence Attachment C3b_follow-up Letter.docx 07/30/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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