Screener and questionnaire - round 1

RANDS during COVID19

OMB: 0920-1298

IC ID: 241593

Information Collection (IC) Details

View Information Collection (IC)

Screener and questionnaire - round 1
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Intro screener and questionnaire Att B - Intro Screen and Questionnaire_UPDATED 05 08 2020.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probability Samples of the US Population  49 FR 37693

12,000 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 12,000 0 12,000 0 0 0
Annual IC Time Burden (Hours) 4,000 0 4,000 0 0 0
Annual IC Cost Burden (Dollars) 95,400 0 95,400 0 0 0

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