View Information Collection (IC)

View Information Collection (IC)

Testing of: NHAMCS, NAMCS, 2010 "Itsinourhands" web site, 2010 CFU, 2010 ACS, and 2010 Mailout Materials
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form NHAMCS-101 National Hospital AmbulatoryMedical Care Survey -- 2009 Panel nhamcs101_071508.pdf No   Paper Only
Form NHAMCS-101(C) National Hospital Ambulatory Medical Care Survey -- 2009 Panel Control Card nhamcs101c_07012008.pdf No   Paper Only
Form NMACS-101(U) Ambulatory Unit Record, National Hospital Ambulatory Medical Care Survey -- 2009 Panel nhamcs101u_07012008.pdf No   Paper Only
Form NMACS-100(ASC) National Hospital Ambulatory Medical Care Survey -- 2009 Ambulatory Surgery Center Patient Record Folio nhamcs100asc_071508.pdf No   Paper Only
Other-NHMACS Draft ASC Respondent Debriefing NHAMCS2enc2.doc No   Paper Only
Other-Lipoprotien Cholesterol Values Worksheet NAMCS2enc1.doc No   Paper Only
Other-Debriefing Questionnaire NAMCS2enc2.doc No   Paper Only
Other-Letter of Explanation NAMCS2enc3.doc No   Paper Only
Other-User Interview Discussion Outline itsinourhands2010website user researchenc.doc No   Paper Only
Form DD-1302 (CFU) Coverage Followup Questionnaire 2010CFU-CPEXenc1.pdf No   Paper Only
Other-Experimental Questions for Undercount Situation 2010CFU-CPEXenc2.doc No   Paper Only
Other-Mailing 1 acs2010materialsenc1.pdf No   Paper Only
Other-Mailing 2 acs2010materialsenc2.pdf No   Paper Only
Other-Mailing 3 acs2010materialsenc3.pdf No   Paper Only
Other-Mailing 4 acs2010materialsenc4.pdf No   Paper Only
Other-Mailing 5 acs2010materialsenc5.pdf No   Paper Only
Other-Mailing 6 acs2010materialsenc6.pdf No   Paper Only
Other-Mailing 7 acs2010materialsenc7.pdf No   Paper Only
Other-Mailing 8 acs2010materialsenc8.pdf No   Paper Only
Other-envelope Census 2010 Mailout Materialsenc1.pdf No   Paper Only
Other-envelope Census 2010 Mailout Materialsenc2.pdf No   Paper Only
Other-letter Census 2010 Mailout Materialsenc3.pdf No   Paper Only
Other-letter Census 2010 Mailout Materialsenc4.pdf No   Paper Only
Other-envelope Census 2010 Mailout Materialsenc5.pdf No   Paper Only
Other-envelope Census 2010 Mailout Materialsenc6.pdf No   Paper Only
Other-postcard Census 2010 Mailout Materialsenc7.pdf No   Paper Only
Other-postcard Census 2010 Mailout Materialsenc8.pdf No   Paper Only
Other-postcard Census 2010 Mailout Materialsenc9.pdf No   Paper Only
Other-postcard Census 2010 Mailout Materialsenc10.pdf No   Paper Only
Other-letter Census 2010 Mailout Materialsenc11.pdf No   Paper Only
Other-letter Census 2010 Mailout Materialsenc12.pdf No   Paper Only
Other-letter Census 2010 Mailout Materialsenc13.pdf No   Paper Only
Other-letter Census 2010 Mailout Materialsenc14.pdf No   Paper Only
Form DY-1(X) Census 2010 Census 2010 Mailout Materialsenc15.pdf No   Paper Only
Other-envelope Census 2010 Mailout Materialsenc16.pdf No   Paper Only

General Government Central Records & Statistical Mgt

 

130 0
   
Individuals or Households
 
   0 %

  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 130 0 0 0 0 0
Annual IC Time Burden (Hours) 150 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
NHMACS Testing Plan NHAMCS2rev.wpd 10/09/2008
NAMCS Testing Plan NAMCS2.wpd 10/07/2008
Itsinourhands 2010 User Website Testing Plan itsinourhands2010website user researchrev2.doc 10/07/2008
2010 CFU Testing Plan 2010CFU-CPEX.wpd 10/07/2008
ACS 2010 Mailout Materials Testing Plan acs2010materials.doc 10/09/2008
Census 2010 Mailout Materials Testing Plan Census 2010 Mailout Materials.wpd 10/09/2008
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.