Screener

[NCEH] Aerosols from cyanobacterial blooms: exposures and health effects in a highly exposed population

Documents and Forms

Document Name Document Type
Form 0920-1316 Screener Form
0920-1316 Survey screener Att5 Screening-Baseline Survey 20200211.docx Form
0920-1316 Survey screener Att5 Screening-Baseline Survey 20200211.docx Form
0920-1316 Screening/Baseline Survey Att5 Screening-Baseline Survey CLEAN 08JAN2021.docx Form
0920-1316 Screening/Baseline Survey Att5 Screening-Baseline Survey CLEAN 08JAN2021.docx Form

Information Collection (IC) Details

IC Title:	Screener	Agency IC Tracking Number:	0920-1316

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-1316	Survey screener	Att5 Screening-Baseline Survey 20200211.docx		No		Paper Only
Form	0920-1316	Screening/Baseline Survey	Att5 Screening-Baseline Survey CLEAN 08JAN2021.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: Epidemiologic studies and surveillance of disease problems.	FR Citation: 57 FR 62812

Number of Respondents: 84	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 77 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	84	0	84
Annual IC Time Burden (Hours)	21	0	21
Annual IC Cost Burden (Dollars)	0	-512	512

Documents for IC

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.