EHDI-PALS Facility Survey Opening

Early Hearing Detection and Intervention - Pediatric Audiology Links to Service (EHDI-PALS) Facility Survey

OMB: 0920-0955

IC ID: 205422

Documents and Forms
Document Name
Document Type
Other-WORD
Other-WORD
Information Collection (IC) Details

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EHDI-PALS Facility Survey Opening
 
No Modified
 
Voluntary
 
42 CFR 241 42 CFR 280f  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Att 3a annualsurveyreview_v4.docx Yes Yes Fillable Printable
Other-WORD Att 3_annualsurveyreview_(word).docx Yes Yes Printable Only

Health Health Care Services

 

800 0
   
Individuals or Households
 
   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 800 0 0 -1,200 0 2,000
Annual IC Time Burden (Hours) 120 0 0 87 0 33
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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