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1 Email Intake Form
Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI's Contact Center, Cancer Information Service (CIS) Clients (NCI)
Appendix 2 Email Intake Form on Cancer.gov
OMB: 0925-0208
OMB.report
HHS/NIH
OMB 0925-0208
ICR 202504-0925-001
IC 219416
1 Email Intake Form
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application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title
APPENDIX 2
Subject
EMAIL INTAKE FORM on CANCER.GOV
Author
Burstyn, Ilene (NIH/NCI) [E]
File Modified
0000-00-00
File Created
2025-07-31
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