Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Data Use Agreement New 250 13 0 Form and Instruction Form #2
Eligibility/Registration Form and Data Submission New 250 1400 0 Form and Instruction Form #1
Hospital Information Form New 750 63 0 Form and Instruction Form #4
Patient Safety Improvement Initiatives Form New 375 31 0 Form and Instruction Form #3
Total burden requested under this ICR: 1625 1507 0  
To view an IC, click on IC Title