Pretest Screener

Utilization of Adequate Provision Among Low to Non-Internet Users

OMB: 0910-0853

IC ID: 230668

Documents and Forms
Document Name
Document Type
Information Collection (IC) Details

View Information Collection (IC)

Pretest Screener CDER
No New

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Screener Adequate Provision Screener.pdf Yes No Paper Only

Health Consumer Health and Safety


63 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 63 0 63 0 0 0
Annual IC Time Burden (Hours) 3 0 3 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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