View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Qualitative Research for Medical Community Baselining Phase II	Agency IC Tracking Number:

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
Other-guide			0990-0379Discussion Guide - HHS MCB II revised.docx		No		Paper Only
Other-Screener			0990-0379_Screener - HHS MCB II (003).docx		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 360	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

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	360	0	360	0	0	0
Annual IC Time Burden (Hours)	360	0	360	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
memo	0990-0379 Memo MCB II revised.docx	05/09/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.