Congential Heart Survey To Recognize Outcomes, Needs, and well-beinG (CH STRONG)

Congenital Heart Survey to Recognize Outcomes, Needs, and Well-Being

OMB: 0920-1122

IC ID: 220010

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Congential Heart Survey To Recognize Outcomes, Needs, and well-beinG (CH STRONG) 0920-1122
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-1122 CHSTRONG Cogenital Heart Survey To Recognize Outcomes, Needs, and well-beinG Att. 3 - English Survey v 2.pdf Yes Yes Fillable Fileable
Form 0920-1122 CHSTRONG Encuesta Cardiaca Congenita para Reconocer los Resultados, las Necesidades y el Bienestar Att. 13 - Spanish Survey v 2.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

Epidemiological Studies and Surveillance of Disease Problems  57 FR 62812

1,661 0
   
Individuals or Households
 
   100 %

  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 1,661 0 1,661 0 0 0
Annual IC Time Burden (Hours) 554 0 554 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att. 6 - CH Strong (screenshots) Att. 6 - Online Survey.pdf 03/13/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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