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
Attachment C – Partner Hospital Champion Survey
New
226
170
0
Form and Instruction
1
Attachment C – Partner Hospital Champion Survey
Attachment E – Interviews with Partner Hospital cardiologists
New
32
16
0
Form and Instruction
3
Attachment E – Interviews with Partner Hospital cardiologists
Attachment F – Interviews with Partner Hospitals that withdraw
New
9
3
0
Instruction
Attachment G – Learning Community Participant Survey
New
400
100
0
Form and Instruction
4
Attachment G – Learning Community Participant Survey
Attachment H – Learning Community Follow-up Survey
New
120
20
0
Form and Instruction
5
Attachment H – Learning Community Follow-up Survey
Interviews with Partner Hospital Champions
New
16
24
0
Form and Instruction
2
Interviews with Partner Hospital Champions
Total burden requested under this ICR:
803
333
0
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