Screen shots of the Clinic Baseline and Annual Reporting
National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Monitoring Activities
Att 7_NBCCEDP Clinic-Level Data Collection Instrument
Clinic-level Cervical Cancer Screening Data
OMB: 0920-1046
ATTACHMENT 7: NBCCEDP Clinic-Level Data Instrument (Screenshots)
Prepared with “dummy” data
Welcome Screen
Health System Data
Clinic Data - Characteristics
Clinic Data – Characteristics, continued
Clinic Data – Characteristics, continued
Clinic Data – Baseline Breast
Clinic Data – Baseline Breast, continued
Clinic Data – Baseline Breast, continued
Clinic Data – Baseline Breast, continued
Clinic Data – Annual Breast
Clinic Data – Annual Breast, continued
Clinic Data – Annual Breast, continued
Clinic Data – Annual Breast, continued
Clinic Data – Annual Breast, continued
Clinic Data – Annual Breast, continued
Clinic Data – Annual Breast, continued
Clinic Data – Annual Breast, continued
Clinic Data – Annual Breast, continued
Clinic Data – Baseline Cervical
Clinic Data – Baseline Cervical, continued
Clinic Data – Baseline Cervical, continued
Clinic Data – Baseline Cervical, continued
Clinic Data – Annual Cervical
Clinic Data – Annual Cervical, continued
Clinic Data – Annual Cervical, continued
Clinic Data – Annual Cervical, continued
Clinic Data – Annual Cervical, continued
Clinic Data – Annual Cervical, continued
Clinic Data – Annual Cervical, continued
Clinic Data – Annual Cervical, continued
Clinic Data – Annual Cervical, continued
Attachment 7 – NBCCEDP Clinic-Level Data Collection Instrument
(Screenshots) Page
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Howe, Will (IMS) |
| File Modified | 0000-00-00 |
| File Created | 2021-01-20 |
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