Provider Survey

[NCBDDD] CDC's Milestone Tracker App User Surveys

OMB: 0920-1397

IC ID: 258177

Information Collection (IC) Details

View Information Collection (IC)

Provider Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Milestone Tracker App Provider Survey (English) H_LTSAE MT Provider Survey_01312023.docx Yes Yes Fillable Fileable
Form and Instruction None Milestone Tracker App Provider Survey (Spanish) H.1_LSTAE MT Provider Survey SPANISH_01312023.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

100,000 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 100,000 0 100,000 0 0 0
Annual IC Time Burden (Hours) 8,333 0 8,333 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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