Request for Non-substantive Change
OMB Control No. 0920-0020 - National Coal Workers' Health Surveillance Program (CWHSP)
Justification for Non-substantive change:
NIOSH is requesting a Non-Substantive Change Request to 0920-0020 to make minor modifications to the Medical Records Request Form to update information on form and make less redundant. There is no change to the approved burden hours.
Existing documents being updated
Non-substantive changes to the Medical Records Request form:
• Removed attention line
• Removed fax number
• Added email address
• Removed option to request spirometry records
• Updated X and Facebook page information
Attachments:
Request for Medical Records Form – modified 15JUL2025
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Lee, Eun Gyung (Emily) (CDC/NIOSH/RHD/FSB) |
| File Modified | 0000-00-00 |
| File Created | 2025-07-18 |