Physician Permission to Contact Potential Survey Respondents

A Study of Primary and Secondary Prevention Behaviors Practiced Among Five-Year Survivors of Colorectal Cancer

OMB: 0920-0815

IC ID: 188830

Information Collection (IC) Details

View Information Collection (IC)

Physician Permission to Contact Potential Survey Respondents
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Permission to Contact Potential Participants Attachment D_LIST OF POTENTIAL STUDY PARTICIPANTS.doc Yes No Fillable Fileable

Health Public Health Monitoring

09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

1,950 0
   
Private Sector Businesses or other for-profits
 
   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 1,950 0 1,950 0 0 0
Annual IC Time Burden (Hours) 423 0 423 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Cover Letter to Physicians Attachment D2_COVER LETTER FOR PHYSICIANS.doc 04/01/2009
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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