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Federal forms, ICRs, and supporting documents

Information Collection Request

SURVEY OF VISITS TO HOSPITAL OUTPATIENT AND EMERGENCY DEPARTMENTS (CONCEPT CLEARANCE)

ICR 198805-0920-002 · OMB 0920-0233 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
110926 SURVEY OF VISITS TO HOSPITAL OUTPATIENT AND EMERGENCY DEPARTMENTS (CONCEPT CLEARANCE) Migrated
ICR Details
0920-0233 198805-0920-002
Historical Active
HHS/CDC
SURVEY OF VISITS TO HOSPITAL OUTPATIENT AND EMERGENCY DEPARTMENTS (CONCEPT CLEARANCE)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/01/1988
Retrieve Notice of Action (NOA) 05/06/1988
  Inventory as of this Action Requested Previously Approved
04/30/1990 04/30/1990
1 0 0
1 0 0
0 0 0
THE PURPOSE OF THIS PROJECT IS TO DEVELOP THE DESIGN FO A NATIONAL SURVEY OF PATIENT VISITS TO HOSPITAL OUTPATIENT AND EMERGEN DEPARTMENTS. THE RESULTING DESIGN WILL BE TESTED AND EVALUATED THROUG ACTUAL DATA COLLECTION. RESULTS WILL BE USED TO IMPLEMENT A NATIONAL SURVEY OF HOSPITAL AMBULATORY SERVICES IN THE FUTURE. THIS REQUEST IS FOR A CONCEPT CLEARANCE.
None
None
No
1
IC Title Form No. Form Name
SURVEY OF VISITS TO HOSPITAL OUTPATIENT AND EMERGENCY DEPARTMENTS (CONCEPT CLEARANCE)
  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 1 0 0 1 0 0
Annual Time Burden (Hours) 1 0 0 1 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.
05/06/1988