OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Colonoscopy Questionnaire

IC 205256 under ICR 201310-0920-003 · OMB 0920-0963.

Documents and Forms
Document Name
Document Type
Other-WORD
Other-WORD
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Colonoscopy Questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Att_G(english).Colonoscopy_questionnaire_screens.pdf Yes Yes Fillable Printable
Other-WORD Att_G(spanish).Colonoscopy_questionnaire_screens.pdf Yes Yes Fillable Printable

Health Immunization Management

 

315 0
   
Individuals or Households
 
   20 %

  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 315 0 0 0 0 315
Annual IC Time Burden (Hours) 131 0 0 0 0 131
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att D Att D. COL protocol instructions.docx 12/10/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.