ACBS Consent and Survey - adult

Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey (ACBS)

OMB: 0920-1204

IC ID: 224743

Information Collection (IC) Details

View Information Collection (IC)

ACBS Consent and Survey - adult
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none ABCS Adult consent and questionnaire Att5e ACBS Adult CnsntQstnnr 20200805.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

23,166 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 23,166 0 3,212 0 0 19,954
Annual IC Time Burden (Hours) 3,861 0 535 0 0 3,326
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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