Annual Progress Report

Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Reporting System

OMB: 0920-0612

IC ID: 191867

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Annual Progress Report
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0612 Annual Progress Report 0612 Att 5 Annual Progress Report Final.pdf No   Fillable Fileable

Health Public Health Monitoring

 

21 0
   
State, Local, and Tribal Governments
 
   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 21 0 21 0 0 0
Annual IC Time Burden (Hours) 336 0 336 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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