English Contact information Form

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

OMB: 0920-1122

IC ID: 220011

Information Collection (IC) Details

View Information Collection (IC)

English Contact information Form 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 English Contact Information Form Att. 18 - English Contact Info Form (CH STRONG).docx No   Paper Only

Health Public Health Monitoring

Epidemiological Studies and Surveillance of Disease Problems  57 FR 62812

237 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 237 0 237 0 0 0
Annual IC Time Burden (Hours) 8 0 8 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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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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