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Federal forms, ICRs, and supporting documents

Information Collection

Medical Record Abstraction - Child

IC 239067 under ICR 202305-0923-001 · OMB 0923-0063.

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

View Information Collection (IC)

Medical Record Abstraction - Child
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Multi-site Study Medical Record Abstraction Form - Child M_Att17b_MedRecAbstrctnForm_Child_20191212_updt.docx No   Paper Only

Health Public Health Monitoring

SORN 09–19–0001, ‘‘Records of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances"  76 FR 4432

50 0
   
Private Sector Businesses or other for-profits
 
   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 700 0 0 0 0 700
Annual IC Time Burden (Hours) 233 0 0 0 0 233
Annual IC Cost Burden (Dollars) 4,935 0 0 0 0 4,935

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.