Information Collection

42 CFR 2.22 Notice to Patients of Federal Confidentiality Requirements

IC 7502 under ICR 202007-0930-001 · OMB 0930-0092.

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Information Collection (IC) Details

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IC Title:	42 CFR 2.22 Notice to Patients of Federal Confidentiality Requirements	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 2.22 Notice to Patients

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13,585	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,658,729	-261,248	1,919,977
Annual IC Time Burden (Hours)	331,746	-52,423	384,169
Annual IC Cost Burden (Dollars)	15,923,798	15,827,799	95,999

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