OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Medical Monitoring Project (MMP) Facility Survey

IC 245510 under ICR 202012-0920-020 · OMB 0920-1340.

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

View Information Collection (IC)

Medical Monitoring Project (MMP) Facility Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Medical Monitoring Project Facility Survey (screenshots) Att 3 MMP facility survey screenshots.docx Yes Yes Fillable Fileable
Form and Instruction n/a Medical Monitoring Project Facility Survey (paper) Att 4 MMP facility survey instrument final_revised 11.20.2020.docx No   Paper Only

Health Health Care Services

 

1,200 0
   
Private Sector Businesses or other for-profits
 
   85 %

  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 1,200 0 1,200 0 0 0
Annual IC Time Burden (Hours) 600 0 600 0 0 0
Annual IC Cost Burden (Dollars) 21,120 0 21,120 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.