Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Serious Medical Procedure (SMR) Form - For Grantee Staff New 195 31 0 Form 1 Serious Medical Procedure (SMR) Request Form
Serious Medical Procedure (SMR) Form - For Healthcare Providers New 195 43 0 Form 1 Serious Medical Procedure (SMR) Request Form
Total burden requested under this ICR: 390 74 0  
To view an IC, click on IC Title