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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Certification and Recertification
New
3510
1379
0
Conflict of Interest
Modified
931500
1085166
0
Consumer authorization forms
New
5610
6
0
Form and Instruction
CMS-10472
Model Authorization Form (Navigators)
Form and Instruction
CMS-10472
Model Aurthorization Form - (Navigators - Spanish)
Training Registration
New
3510
1327
0
Form and Instruction
CMS-10472
Training Quality Questionnaire
Form and Instruction
CMS-10472
Sample Training Completion Certificate
Form and Instruction
CMS-10472
Registration Portal
Total burden requested under this ICR:
944130
1087878
0
To view an IC, click on IC Title