Participants Call and Interview

The Cardiovascular, Heart Diseases Health Study

Documents and Forms

Document Name Document Type
Form 2 Participants Call and Interview Form and Instruction
2 Interview Form ATT 8 - CHS Informant Interview form.pdf Form and Instruction
3 CHS Call ATT 8 - Semi-annual Surveillance Call form.doc Form and Instruction
1 Interview Script ATT 8 - CHS Informant Interview Script.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Participants Call and Interview	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	2	Interview Form	ATT 8 - CHS Informant Interview form.pdf	Yes	Yes	Paper Only
Form and Instruction	3	CHS Call	ATT 8 - Semi-annual Surveillance Call form.doc	Yes	Yes	Paper Only
Form and Instruction	1	Interview Script	ATT 8 - CHS Informant Interview Script.doc	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 467	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	467	467
Annual IC Time Burden (Hours)	280	280
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.