Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Anesthesis Modified 15 15 0 Form and Instruction 0917-0009-8
Audiology Modified 7 1 0 Form and Instruction 0917-0009-12
Dental Privileges Modified 150 50 0 Form and Instruction 0917-0009-9
Indian Health Service Medical Staff Credentials and Privileges Files Modified 570 570 0 Form and Instruction 0917-0009-1
Medical Privileges Request Form Modified 325 325 0 Form and Instruction 0917-0009-4
OB-GYN Modified 20 20 0 Form and Instruction 0917-0009-5
Optometry Removed 0 0 0 Form NA
Pathology Modified 3 1 0 Form and Instruction 0917-009-15
Podiatry Modified 7 1 0 Form and Instruction 0917-0009-13
Psychiatry Modified 13 13 0 Form and Instruction 0917-0009-7
Psychology Modified 30 5 0 Form and Instruction 0917-0009-11
Radiology Modified 8 3 0 Form and Instruction 0917-0009-14
Reaapointment Request Modified 190 190 0 Form and Instruction 0917-0009-3
Reference Letter Modified 1710 570 0 Form and Instruction 0917-0009-2
Surgery Modified 20 20 0 Form and Instruction 0917-0009-6
Total burden requested under this ICR: 3068 1784 0  
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