Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Data Use Agreement Modified 304 15 0 Form and Instruction Form #2 Data Use Agreement
Eligibility/Registration Form and Data Submission Modified 304 1702 0 Form and Instruction Form #1 Eligibility and Registration Form
Hospital Information Form Modified 912 76 0 Form and Instruction Form #3 Hospital Information Form
Patient Safety Improvement Initiatives Form Removed 0 0 0 Form and Instruction Form #3 Patient Safety Improvement Initiatives Form
Total burden requested under this ICR: 1520 1793 0  
To view an IC, click on IC Title