View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

LAN Documents (CMS-10616, CMS-10617 and CMS-10618)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10616 Webinar Post-Session Evaluation Form - Lan Update CMS-10616 GenIC10 Instrument - Webinar Post-Session Eval Form.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10617 Webinar Post-Session Evaluation Form - Listening CMS-10617 GenIC11 Instrument - Webinar Post-Session Eval Form.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10618 Webinar Post-Session Evaluation - Learnings CMS-10618 GenIC12 Instrument - Webinar Post-Session Eval Form.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

1,680 336
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,680 0 1,680 0 0 0
Annual IC Time Burden (Hours) 56 0 56 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Burden Table for GenIC#10 11 and 12 0938-1297 Burden Table for GenICs 10 11 and 12.docx 04/14/2016
CMS-10616 Supporting Statement CMS-10616 Supporting Statement GenIC10 Webinar Post Session Evaluation - LAN Updates.docx 04/14/2016
CMS-10617 Supporting Statement CMS-10617 Supporting Statement GenIC11 Webinar Post Session Evaluation - LAN Listening.docx 04/14/2016
Supporting Statement 10618 CMS-10618 Supporting Statement GenIC12 Webinar Post Session Evaluation - LAN Learning.docx 04/14/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.