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Survey of Primary Care Physicians Practices Regarding Prostate Cancer Screening
Survey of Primary Care Physicians' Practices Regarding Prostate Cancer Screening
OMB: 0920-0746
IC ID: 179788
OMB.report
HHS/CDC
OMB 0920-0746
ICR 200704-0920-002
IC 179788
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0746 can be found here:
2008-03-27 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Survey of Primary Care Physicians Practices Regarding Prostate Cancer Screening
Form and Instruction
Survey of Primary Care Physicians Practices Regarding Pr
Attachment 4. Data Collection Instrument.doc
Form and Instruction
Attachment 6. Signature Postcard.doc
Attachment 6. Signature Postcard
IC Document
Attachment 5. Survey Cover Letters.doc
Attachment 5. Survey Cover Letters
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Survey of Primary Care Physicians Practices Regarding Prostate Cancer Screening
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
42 CFR 301
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
None
Survey of Primary Care Physicians Practices Regarding Prostate Cancer Screening
Attachment 4. Data Collection Instrument.doc
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,000
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
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
2,000
0
2,000
0
0
0
Annual IC Time Burden (Hours)
1,000
0
1,000
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment 6. Signature Postcard
Attachment 6. Signature Postcard.doc
Attachment 5. Survey Cover Letters
Attachment 5. Survey Cover Letters.doc
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.