OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Interview with Medical Care Providers

IC 185915 under ICR 200807-0920-005 · OMB 0920-0797.

Documents and Forms
Document Name
Document Type
Other-Interview Guide
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Interview with Medical Care Providers
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Interview Guide Att 9A. Medical Providers Interview Guide.doc No No Paper Only

Health Illness Prevention

 

27 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 27 0 0 27 0 0
Annual IC Time Burden (Hours) 27 0 0 27 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment 9B - consent form Att 9B. Consent Form for Medical Providers Interview.doc 07/14/2008
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.