Case Questionnaire - Dog Owner

Canine Leptospirosis Surveillance in Puerto Rico

OMB: 0920-1170

IC ID: 225039

Information Collection (IC) Details

View Information Collection (IC)

Case Questionnaire - Dog Owner
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Case Questionnaire - Dog Owner Att E--Case_Questionnaire_2016_9_22 lepto PR.doc No   Paper Only
Form none Case Questionnaire for Dog Owner - Spanish Att E--Case_Questionnaire_2016_12_19_Spanish.doc No   Paper Only

Health Illness Prevention

Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

624 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 624 0 624 0 0 0
Annual IC Time Burden (Hours) 52 0 52 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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