Mobility Planning Tool

Older Adult Safe Mobility Assessment Tool

Attach D3 Mobility Planning Tool (MPT)

Mobility Planning Tool (MPT)

OMB: 0920-1005

Document [doc]
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Attachment D3


Mobility Planning Tool (MPT)


Form Approved
OMB No: 0920-1005
Exp. Date: xx/xx/xxxx

Public Reporting burden of this collection of information is estimated at 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NW, MS D-74, Atlanta, GA  30333; Attn:  PRA (0920-1005).























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File Typeapplication/msword
File TitleGirls Soccer Survey
AuthorMelissa Schiff
Last Modified ByAngel, Karen C. (CDC/ONDIEH/NCIPC)
File Modified2015-07-23
File Created2015-07-23

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