NBCCEDP Clinic-Level Data Instrument (Cervical)

National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Monitoring Activities

OMB: 0920-1046

IC ID: 233708

Information Collection (IC) Details

View Information Collection (IC)

NBCCEDP Clinic-Level Data Instrument (Cervical) 0920-1046
 
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 0920-1046 NBCCEDP Clinic-Level Data Collection Instruments (Cervical) Att 6 - NBCCEDP Clinic-Level Data Collection Instruments.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

70 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 420 0 0 0 0 420
Annual IC Time Burden (Hours) 315 0 -35 0 0 350
Annual IC Cost Burden (Dollars) 17,989 0 0 0 0 17,989

Title Document Date Uploaded
NBCCEDP Clinic-Level Data Instrument (Screenshots) Att 6a - NBCCEDP Clinic Level Data Collection Instruments (screenshots).docx 11/02/2021
NBCCEDP Clinic-Level Data Collection Introductory Email Att 6b - NBCCEDP Clinic-Level Data Collection Introductory Email.docx 11/15/2021
NBCCEDP Clinic-Level Data Collection Reminder Email Att 6c - NBCCEDP Clinic-Level Data Collection Reminder Email.docx 11/15/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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