Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medical Office Eligibility and Registration Form Modified 85 4 0 Form and Instruction Form #1 Medical Office Eligibility and Registration Form
Medical Office SOPS Data Submission Emails Modified 85 85 0 Form and Instruction Form #4 Medical Office Data Submission Emails
Medical Office SOPS Data Use Agreement Modified 85 4 0 Form and Instruction Form #3 Medical Office SOPS Data Use Agreement
Medical Office Site Information Form Modified 2550 213 0 Form and Instruction Form #2 Medical Office Site Information Form
Total burden requested under this ICR: 2805 306 0  
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