Appointment Reminder Telephone Script

Human Health Effects of Drinking Water Exposures to Per- and Polyfluoroalkyl Substances (PFAS) at Pease International Tradeport, Portsmouth, NH (The Pease Study)

Documents and Forms

Document Name Document Type
Form 0923-0061 Appointment Reminder Telephone Script Form and Instruction
0923-0061 Appointment Reminder Telephone Script P_Att10_AppointmentReminderTelScript_clean_20200729_clean.docx Form and Instruction
0923-0061 Appointment Reminder Telephone Script P_Att10_AppointmentReminderTelScript_clean_20200729_clean.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Appointment Reminder Telephone Script	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	0923-0061	Appointment Reminder Telephone Script	P_Att10_AppointmentReminderTelScript_clean_20200729_clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Records of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances	FR Citation: 76 FR 4432

Number of Respondents: 542	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	542	542
Annual IC Time Burden (Hours)	45	45
Annual IC Cost Burden (Dollars)	1,128	1,128

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.