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Clinic Visit Checklist and Body Measurements - Licensed Anglers
Biomonitoring of Great Lakes Populations Program III
OMB: 0923-0056
IC ID: 226326
OMB.report
HHS/TSDR
OMB 0923-0056
ICR 201801-0923-002
IC 226326
( )
Documents and Forms
Document Name
Document Type
Clinic Visit Checklist and Body Measurements - Licensed Anglers
Form and Instruction
Clinic Visit Checklist and Body Measurements - Licensed
8a.Clinicvisitchecklist_LicAng revised.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Clinic Visit Checklist and Body Measurements - Licensed Anglers
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
NA
Clinic Visit Checklist and Body Measurements - Licensed Anglers
8a.Clinicvisitchecklist_LicAng revised.docx
NA
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
134
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
134
0
0
0
0
134
Annual IC Time Burden (Hours)
78
0
0
0
0
78
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.