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Federal forms, ICRs, and supporting documents

Information Collection

MD STARnet Women Living with Muscular Dystrophy Survey

IC 258573 under ICR 202302-0920-006 · OMB 0920-1405.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

MD STARnet Women Living with Muscular Dystrophy Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Women Living with Muscular Dystrophy Survey (paper) Attachment D_MD STARnet Women Living with MD Survey.docx No   Paper Only
Form and Instruction None Women Living with Muscular Dystrophy Survey (screen shot of intro to the web-based form) 2023 2 13 Attachment D-2_Introduction to Women's Web-based Survey.docx Yes Yes Fillable Fileable
Form and Instruction None Women Living with Muscular Dystrophy Survey (telephone interview) 2013 2 13 Attachment F_MD STARnet Women Living with MD Phone Script.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

472 0
   
Individuals or Households
 
   60 %

  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 472 0 472 0 0 0
Annual IC Time Burden (Hours) 157 0 157 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.