Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.
2016 Ambulatory Surgery Center Patient Record Form	Removed	0	0	0	Form and Instruction	0920-0278
2016 Ambulatory Surgery Center Patient Record Form	Removed	0	0	0	Instruction
2016 Emergency Department Patient Record Form	Removed	0	0	0	Form and Instruction	0920-0278
2016 Emergency Department Patient Record Form	Removed	0	0	0	Instruction
2016 Outpatient Department Patient Record Form	Removed	0	0	0	Form and Instruction	0920-0278
2016 Outpatient Department Patient Record Form	Removed	0	0	0	Instruction
Ambulatory Unit Induction Interview 2018	Modified	578	145	6872	Form and Instruction	none
Hospital Induction Interview 2018	Modified	340	255	23827	Form and Instruction	none
Reabstraction Telephone Call	Modified	17	1	67	Instruction
Retrieve Medical Records	Modified	36720	612	11750	Instruction
Retrieve Medical Records Records (Reabstraction)	Modified	170	3	54	Instruction
Total burden requested under this ICR:		37825	1016	42570
To view an IC, click on IC Title