View Information Collection (IC)

View Information Collection (IC)

IC Title:	NAMCS Feasibility Study	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	none	Physician Survey	0920-0222_Attach 1 - NAMCS Physician Survey_3 072214.docx		Yes	Yes	Fillable Fileable
Form and Instruction	none	Medical Organization Survey	0920-0222_Attach 2 - NAMCS Medical Organization Survey3 072214.docx		Yes	Yes	Fillable Fileable
Form and Instruction	none	Phys and Organization Survey	0920-0222_Attach 3 - NAMCS Physician and Medical Organization Survey3 072214.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,268	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	2,268	0	2,268	0	0	0
Annual IC Time Burden (Hours)	779	0	779	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	0920-0222 QDRL Physician Feasibility 072414.docx	07/25/2014
Letters	0920-0222 Attach 4 - NAMCS Feasibility Advance Letters.docx	07/25/2014

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