Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
ASC Patient Record Form Modified 10700 1070 0 Form and Instruction NHAMCS 100 (ASC)
Ambulatory Unit Induction Modified 1690 1690 0 Form and Instruction NHAMCS-101/U
Cervical Cancer Screening Supplement Modified 250 63 0 Form NHAMCS-906
ED Patient Record Form Modified 22000 2567 0 Form NHAMCS 100 (ED)
Hospital Induction Modified 470 431 0 Form and Instruction NHAMCS-101
Medical Record Clerk/ Pulling and re-filing OPD Patient Record Removed 0 0 0 Instruction
OPD Patient Record Form Modified 25000 2500 0 Form NHMACS 100 (OPD)
Pulling and re-filing Patient Records Modified 51876 865 0 Instruction
Total burden requested under this ICR: 111986 9186 0  
To view an IC, click on IC Title