Screener

Prevent Hepatitis Transmission among Persons who Inject Drugs

OMB: 0920-1116

IC ID: 219537

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

View Information Collection (IC)

Screener
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Screener Att 3A Screener.docx Yes No Paper Only

Health Illness Prevention

 

332 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 332 0 332 0 0 0
Annual IC Time Burden (Hours) 55 0 55 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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