Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Induction Interview Providers (NAMCS-1) New 234 117 0 Form and Instruction 0920-0234 Att C3- 2016 NAMCS 1 CHC 122115
Introduction Interview - Service Delivery Site (NAMCS-201) New 104 52 0 Form and Instruction 0920-0234 Att C4- 2016 NAMCS-201
Patient Record Form (NAMCS-1) New 690 161 0 Form and Instruction 0920-0234 Att D2 2016 NAMCS PRF
Physician Abstracts -Patient Record Form (NAMCS-30) Modified 7770 1813 0 Form and Instruction 0920-0234 Att D2 2016 NAMCS PRF 122115
Physician Induction Inverview (NAMCS-1) Modified 2590 1943 0 Form and Instruction 0920-0234 Att C2 - 2016 NAMCS 1 TradPhys
Prepare and Transmit EHR (MU Onboarding) Modified 130 130 0 Instruction
Pulling and re-filing Medical Record Forms (FR abstracts) Modified 66030 1101 0 Instruction
Pulling, Re-Filing Medical Forms (FR abstracts) Modified 6330 106 0 Instruction
Re-abstraction Study New 720 12 0 Form and Instruction 0920-0234 Att C1 NAMCS-1A
Total burden requested under this ICR: 84598 5435 0  
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