WISEWOMAN Program Minimum Data Elements (MDE)

[NCCDPHP] Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Reporting System

OMB: 0920-0612

IC ID: 37802

Information Collection (IC) Details

View Information Collection (IC)

WISEWOMAN Program Minimum Data Elements (MDE) 0920-0612-23HT
 
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 0920-0612 WISEWOMAN Program MDE Manual Edition 18.3R wisewoman_MDE_manual_18.3.pdf Yes Yes Fillable Fileable
Instruction Att 6 MDE Submission Instructions.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

40 0
   
State, Local, and Tribal Governments
 
   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 80 0 10 0 0 70
Annual IC Time Burden (Hours) 2,000 0 250 0 0 1,750
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Screenshot of the WISEWOMAN Web Portal Att 4a Web Portal Screenshot.png 08/11/2022
Screenshot (Example) of Uploading MDE Files Att 4b Web Portal Upload Screenshot.png 08/11/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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