Enrollment Questionnaire for Clinics and Shelter

Canine Leptospirosis Surveillance in Puerto Rico

OMB: 0920-1170

IC ID: 225035

Information Collection (IC) Details

View Information Collection (IC)

Enrollment Questionnaire for Clinics and Shelter 16BGH
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Enrollment Questionnaire - Spanish Att C--Site_Enrollment_Questionnaire_2016_12_19_Spanish.docx No   Paper Only
Form none Enrollment Questionnaire Att C--Site_Enrollment_Questionnaire_2016_9_22.docx No   Paper Only

Health Illness Prevention

Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

26 0
   
Private Sector Businesses or other for-profits
 
   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 26 0 26 0 0 0
Annual IC Time Burden (Hours) 2 0 2 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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