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Att 3a_Screener Instrument for In-depth Interviews and Focus Group

IC 224989 under ICR 202206-0920-015 · OMB 0920-1169.

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Att 3a_Screener Instrument for In-depth Interviews and Focus Group 0920-21FV
 
Yes Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WRD Att 3a Screening Instrument-IDI and FG_reinstatement_07-14-20.docx No   Paper Only

Health Illness Prevention

 

2,165 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 2,165 0 0 0 0 2,165
Annual IC Time Burden (Hours) 72 0 0 0 0 72
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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