Form 8 Email Intake Form on Cancer.gov

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

E-mail Clients

OMB: 0925-0208

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NCI/Office of Communications and Public Liaison

APPENDIX 2

EMAIL INTAKE FORM on CANCER.GOV






Found at: https://www.cancer.gov/contact/email-us





Public reporting burden for this collection of information is estimated to average 10 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0208). Do not return the completed form to this address.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleAPPENDIX 2
SubjectEMAIL INTAKE FORM on CANCER.GOV
AuthorBurstyn, Ilene (NIH/NCI) [E]
File Modified0000-00-00
File Created2021-01-20

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