Landline Screener

2019 Field Test Behavioral Risk Factor Surveillance System (BRFSS)

OMB: 0920-1061

IC ID: 214636

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Landline Screener 0920-14AYC
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1061 BRFSS Landline Screen Script Attachment 8 Landline and Cell Phone Screener.docx NA No   Fillable Fileable

Health Public Health Monitoring

 

375,000 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 375,000 0 0 0 0 375,000
Annual IC Time Burden (Hours) 6,250 0 0 0 0 6,250
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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