Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Data Use Agreement Modified 304 15 0 Form and Instruction Form # 2
Eligibility/Registration Form and Data Submission Modified 304 319 0 Form and Instruction Form # 1
Hospital Information Form Modified 912 76 0 Form and Instruction Form # 3
Total burden requested under this ICR: 1520 410 0  
To view an IC, click on IC Title