Information Collection

CDC/CLSI POC Fingerstick Glucose Testing Survey (FGS 1-3)

IC 217102 under ICR 201506-0920-004 · OMB 0920-1088.

Documents and Forms

Document Name Document Type
CDC/CLSI POC Fingerstick Glucose Testing Survey (FGS 1-3) Form and Instruction
CDC/CLSI Point-of-Care Fingerstick Glucose Testing Surve Appendix C Survey_Merged_Screenshots3-27-15.pdf Form and Instruction
CDC/CLSI Point-of-Care Fingerstick Glucose Testing Surve Appendix D Surveys_2_and_3_Merged_Screenshots3-27-15.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CDC/CLSI POC Fingerstick Glucose Testing Survey (FGS 1-3)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Form and Instruction	None	CDC/CLSI Point-of-Care Fingerstick Glucose Testing Survey (FGS1)	Appendix C Survey_Merged_Screenshots3-27-15.pdf	None	Yes	Yes	Fillable Fileable
Form and Instruction	None	CDC/CLSI Point-of-Care Fingerstick Glucose Testing Survey (FGS2,3)	Appendix D Surveys_2_and_3_Merged_Screenshots3-27-15.pdf	None	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 74,070	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	74,070	74,070
Annual IC Time Burden (Hours)	18,518	18,518
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.