PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Request for Certification as Rural Health Clinic and Rural Health Clinic Survey Report Form and Supporting Regulations in 42 CFR 491.1-491.11
Modified
766
192
0
Form and Instruction
CMS-29
Request to Establish Eligibility to Participate in the Health Insurance for the Aged and Disabled Program to Provide RHC Services
Total burden requested under this ICR:
766
192
0
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