Att 3b_ Web-Based Screener & Informed Consent

Understanding the Needs of Ovarian Cancer Survivors

OMB: 0920-1314

IC ID: 242254

Information Collection (IC) Details

View Information Collection (IC)

Att 3b_ Web-Based Screener & Informed Consent 0920-19BHM
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920- Ovarian Cancer Survivorship Survey Screener OCS Att 3b web-based questionnaire Final.pdf Yes Yes Fillable Fileable

Health Illness Prevention

 

105 0
   
Individuals or Households
 
   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 105 0 105 0 0 0
Annual IC Time Burden (Hours) 88 0 88 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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