Substance-Related and Addictive Disorders Current Evaluation Form

Individual Specific Medical Evaluation Forms (15)

OMB: 0420-0550

IC ID: 224326

Information Collection (IC) Details

View Information Collection (IC)

Substance-Related and Addictive Disorders Current Evaluation Form PC-262-6
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction PC-262-6 Substance-Related and Addictive Disorders Current Evaluation Form Substance_Addictive_Disorders_Current_Eval.docx Yes No Fillable Printable

International Affairs and Commerce International Development and Humanitarian Aid

 

373 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 373 0 373 0 0 0
Annual IC Time Burden (Hours) 1,026 0 1,026 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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