Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Data Files Submission Modified 340 340 0 Form and Instruction Attachment D
Data Use Agreement Modified 340 17 0 Form and Instruction Form # 2
Eligibility/Registration Form and Data Submission Modified 340 17 0 Form and Instruction Form # 1
Hospital Information Form Modified 1020 85 0 Form and Instruction Form # 3
Total burden requested under this ICR: 2040 459 0  
To view an IC, click on IC Title