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
Hospital Restraint/Seclusion Death Report Worksheet
New
24500
8085
0
Form
CMS-10455
Health Death Report Form
Form and Instruction
CMS-10455
Intake
Form and Instruction
CMS-10455
Screenshot
Total burden requested under this ICR:
24500
8085
0
To view an IC, click on IC Title
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The .gov means it's official.
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