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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Developmental Studies to Improve the National Health Care Surveys
Agency IC Tracking Number:
17EH
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
NA
Contact Information Verification
Attachment B-Contact Information Verification.doc
NA
No
Paper Only
Form and Instruction
NA
Telephone Scheduling Script
Attachment D-Scheduling Script for Interviews.doc
NA
No
Paper Only
Form and Instruction
NA
Telephone Interview - IDD Exploratory Work
Attachment E - IDD Telephone Interview Protocol.docx
NA
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0167 - Health Resources Utilization Statistics
FR Citation:
49 FR 37697
Number of Respondents:
195
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
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
195
0
195
0
0
0
Annual IC Time Burden (Hours)
45
0
45
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Research Determination
Attach A-HSRD form and protocol_10-26-16.pdf
11/14/2016
Cover Letter
Attachment C-Advance Package NCHS Cover Letter Email.doc
11/14/2016
Supporting Statement A
State agency interviews SSA 111016.doc
11/15/2016
Supporting Statement B
State agency interviews SSB 111016.doc
11/15/2016
Thank You Letter
Attachment F-Thank You Letter for Interview.doc
11/16/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.