Specimen collection - fingerprick

Information Collection on Soil-transmitted Helminth Infections in Alabama and Mississippi

Documents and Forms

Document Name Document Type
fingerprick IC.docx Other-Blood Specimen Collection

Information Collection (IC) Details

IC Title:	Specimen collection - fingerprick	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Blood Specimen Collection			fingerprick IC.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 958	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	958	958
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	579	579

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.