Agency Schedule Detail

Authorization Number : 440-0300

Agency Series No. : 47-02

Status : Active

Agency Web Link :

Agency : DOH

Confidential Description : N/A-Load

Division : DOH6000

Vital Description : N/A-Load

Section : DOH60006047

Record Title : Medical Records/IHSAP

Revision : 0

Record Description : Infant High Risk Questionnaire & Infant Hearing Assessment Reporting Form. In re: State Infant Hearing Screening & Assess- ment Program. Information gathered & maintained for purpose of data analysis on retrospective, as well as prospective longitudina

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain 2 years, then destroy	No value at Conversion	Electronic	Erase
Maintain questionnaire and Hearing Assessment Reporting form until information is tabulated/entered, then destroy. Maintain the final report for 3 years then destroy if of no historical value to State Archives	No value at Conversion	Paper	Other

Approvals

Status	Name	Title	Date
Approved	Transfer User	Records Viewer	7/27/1992 12:00:00 AM

Notes

Date	Reason	User