Recruitment Screener (English/Spanish)

Study to Estimate Radiation Doses and Cancer Risk From Radioactive Fallout From The Trinity Nuclear Test (NCI)

OMB:

IC ID: 223117

Documents and Forms
Information Collection (IC) Details

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Recruitment Screener (English/Spanish)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 screener ATTACHMENT 5 - Screener.docx No   Paper Only

Health Health Care Services

Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service  67 FR 60743

315 0
   
Individuals or Households
 
   0 %

  Requested 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 315 0 315 0 0 0
Annual IC Time Burden (Hours) 53 0 53 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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