Information Collection

OS Participants

IC 7310 under ICR 201606-0925-004 · OMB 0925-0414.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 33 OS Participants	Form and Instruction
33 Medical History Update F33-OMB-2013.pdf	Form and Instruction
20 Personal Information Update Form 20.pdf	Form and Instruction
151 Activities of Daily Life WHI Form 151 Activities of Daily Life.pdf	Form and Instruction
156 Supplemental Questionaire F156 Supplemental-OMB-01-22-13.pdf	Form and Instruction
F156S Supplemental OMB-1-22-13.pdf F156S Supplemental OMB-1-22-13	IC Document

IC Title:

OS Participants

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	33	Medical History Update	F33-OMB-2013.pdf	No	No	Paper Only
Form and Instruction	20	Personal Information Update	Form 20.pdf	No	No	Paper Only
Form and Instruction	151	Activities of Daily Life	WHI Form 151 Activities of Daily Life.pdf	No	No	Paper Only
Form and Instruction	156	Supplemental Questionaire	F156 Supplemental-OMB-01-22-13.pdf	No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 41,495

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-41,495	41,495
Annual IC Time Burden (Hours)	-13,832	13,832
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
F156S Supplemental OMB-1-22-13	F156S Supplemental OMB-1-22-13.pdf	05/29/2013

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