Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
HOME HEALTH AGENCY (HHA) MEDICARE AND MEDICAID SURVEY REPORT FORMS FOR HHA CONDITIONS OF PARTICIPATION Migrated 6000 97500 0 Form 36 SP
Form HCFA-1515
Form 1572, 36 U3
Total burden requested under this ICR: 6000 97500 0  
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