Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Ambulatory Unit Induction Interview 2020 Modified 273 68 4019 Form and Instruction none
Ambulatory Unit Induction Interview 2021 New 820 205 12070 Form and Instruction NA
Hospital Induction Interview 2020 Modified 137 69 8041 Form and Instruction none
Hospital Induction Interview 2021 Modified 410 205 24063 Form and Instruction NA
Reinterview Study 2020 Modified 42 11 1232 Form and Instruction none
Reinterview Study 2021 Modified 125 31 3668 Form and Instruction none
Retrieve Medical Records 2020 Modified 13700 228 4384 Instruction
Retrieve Medical Records 2021 Modified 41000 683 13120 Instruction
Total burden requested under this ICR: 56507 1500 70597  
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