Att 3c_Web-based Screener (ONLY)

Understanding the Needs of Ovarian Cancer Survivors

OMB: 0920-1314

IC ID: 242265

Information Collection (IC) Details

View Information Collection (IC)

Att 3c_Web-based Screener (ONLY) 0920-19BHM
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920- Web-based Screener (Ovarian Cancer Survivorship Survey) OCS Att 3c web-based screener & informed consent Final.pdf Yes Yes Fillable Fileable

Health Illness Prevention

 

100 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 100 0 100 0 0 0
Annual IC Time Burden (Hours) 3 0 3 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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