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Federal forms, ICRs, and supporting documents

Information Collection

Medical Record Abstraction Category 2

IC 223239 under ICR 201608-0920-016 · OMB 0920-1172.

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

Medical Record Abstraction Category 2
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Att5l MedRecAbstract.docx No   Paper Only

Health Public Health Monitoring

 

210 0
   
Private Sector Not-for-profit institutions
 
   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 420 0 420 0 0 0
Annual IC Time Burden (Hours) 21 0 21 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.