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
ASL Patient Record Form
Modified
5400
630
0
Form
none
Ambulatory Surgery
Ambulatory Unit Induction
Modified
1779
445
0
Instruction
Cervical Cancer Screening Supplement
Removed
0
0
0
Form
unnumbered
Att. T. Cervical Cancer Screening Supplement
ED Patient Record Form
Modified
11300
1318
0
Form
none
ED Screenshots
Hospital Induction Form
Modified
482
723
0
Form
none
Hospital Induction Interview
Medical Record Reabstraction
Modified
720
12
0
Instruction
OPD Patient Record Form
Modified
15600
2600
0
Form
none
OPD Screenshots
Pulling and re-filing Patient Records
Modified
97090
1618
0
Instruction
Reabstraction Telephone Call
Modified
72
6
0
Instruction
Total burden requested under this ICR:
132443
7352
0
To view an IC, click on IC Title
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