Information Collection

Clinic Visit and Body Measurements - Burmese Immigrants and Descendants

IC 226331 under ICR 201801-0923-002 · OMB 0923-0056.

Documents and Forms

Document Name Document Type
Form 0923-0056 Clinic Visit and Body Measurements - Burmese Immigrants and Descendants Form and Instruction
0923-0056 Clinic Visit Checklist and Body Measurements - Burmese I 8b.ClinicVisitChklst_Burm revised.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Clinic Visit and Body Measurements - Burmese Immigrants and Descendants	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	0923-0056	Clinic Visit Checklist and Body Measurements - Burmese Immigrants and their Descendants	8b.ClinicVisitChklst_Burm revised.docx	NA	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 34	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	34	34
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	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.