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Federal forms, ICRs, and supporting documents

Information Collection Request

U.S. CONSUMER PRODUCT SAFETY COMMISSION INJURY STUDY PRETEST OF INJURY SURVEILLANCE DATA COLLECTION IN FREESTANDING AMBULATORY CARE CENTERS

ICR 198605-3041-002 · OMB 3041-0076 · Historical Active

Forms and Documents
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IC IDCollectionTypeStatusForm
149173 U.S. CONSUMER PRODUCT SAFETY COMMISSION INJURY STUDY PRETEST OF INJURY SURVEILLANCE DATA COLLECTION IN FREESTANDING AMBULATORY CARE CENTERS Migrated
ICR Details
3041-0076 198605-3041-002
Historical Active
CPSC
U.S. CONSUMER PRODUCT SAFETY COMMISSION INJURY STUDY PRETEST OF INJURY SURVEILLANCE DATA COLLECTION IN FREESTANDING AMBULATORY CARE CENTERS
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/25/1986
Retrieve Notice of Action (NOA) 05/02/1986
  Inventory as of this Action Requested Previously Approved
06/30/1987 06/30/1987
3,000 0 0
500 0 0
0 0 0
FREESTANDING AMBULATORY CARE CENTERS (ACC'S) ARE A POPULAR NEW SOURCE OF CARE. THEY NOW COMPETE WITH HOSPITAL EMERGENCY ROOMS FO INJURIES AND OTHER MINOR EMERGENCIES. THIS PRETEST WILL EVALUATE THE FEASIBILITY OF SETTING UP AN ACC BASED SYSTEM OF INJURY SURVEILLANCE. AFFECTED PUBLIC WILL BE PERSONS TREATED AT ACC'S FOR PRODUCT-RELATED INJURIES.
None
None
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,000 0 0 3,000 0 0
Annual Time Burden (Hours) 500 0 0 500 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/02/1986