CTSU Patient Enrollment Transmittal Form (Attachment A15)

CTEP Branch Support Contracts Forms and Surveys (NCI)

OMB: 0925-0753

IC ID: 225866

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CTSU Patient Enrollment Transmittal Form (Attachment A15)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 15 patient Enrollment Transmittal Form Attachment_A15_ptentf_06152018.pdf No   Paper Only

Health Public Health Monitoring

Clinical Basic and Population-based Research Studies of the National Institutes of Health  67 FR 60742

12 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 144 0 0 0 0 144
Annual IC Time Burden (Hours) 24 0 0 0 0 24
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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