ACBS Data Submission Layout - Adult

[NCEH] Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey (ACBS)

Documents and Forms

Document Name Document Type
Att5g ACBS Adult DataSbmssnLayout 2023 Rev.docx Other-Data Submission Layout - Adult
Att5g ACBS Adult DataSbmssnLayout 2023 Rev.docx Other-Data Submission Layout - Adult

Information Collection (IC) Details

IC Title:	ACBS Data Submission Layout - Adult	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Data Submission Layout - Adult			Att5g ACBS Adult DataSbmssnLayout 2023 Rev.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	480	480
Annual IC Time Burden (Hours)	1,240	1,240
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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