Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Certification for Continued Listing Form Modified 17 9 0 Form and Instruction Form #6
Disclosure Form - Revised Modified 17 9 0 Form and Instruction Form #5
Information Form - Revised Modified 33 17 0 Form and Instruction Form #3
Patient Safety Confidentiality Complaint Form Modified 50 17 0 Form and Instruction Form #1
Patient Safety Organization Certification for Initial Listing Form Modified 33 17 0 Form and Instruction Form #4
Two Bona Fide Contracts Requirement Form Modified 33 8 0 Form and Instruction Form #2
Total burden requested under this ICR: 183 77 0  
To view an IC, click on IC Title