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
NAMCS EMR/EHR Mail Survey (Line 6)
Modified
5604
1868
0
Form and Instruction
6
NAMCS EMR/EHR Mail Survey (Line 6)
NAMCS-1 Physician Induction Interview (Line 1)
Modified
3657
1707
0
Form and Instruction
1
NAMCS-1 Physician Induction Interview (Line 1)
NAMCS-201 Community Health Center Induction Interview (Line 2)
Modified
104
35
0
Form and Instruction
2
NAMCS-201 Community Health Center Induction Interview (Line 2)
NAMCS-30 Patient Record form (Line 3)
Modified
22140
3321
0
Form and Instruction
3
NAMCS-30 Patient Record form (Line 3)
NAMCS-CCS Cervical Cancer Screening Supplement (Line 5)
Modified
464
116
0
Form
5
NAMCS-CCS Cervical Cancer Screening Supplement (Line 5)
Pulling and re-filing Patient Record form (Line 4)
Modified
19500
325
0
Form
4
Pulling and re-filing Patient Record form (Line 4)
Total burden requested under this ICR:
51469
7372
0
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