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

View Information Collection (IC)

Advancing the Collection and Use of Patient –Reported Outcomes through Health Information Technology
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Yes Yes Fillable Fileable
Form and Instruction 2 Yes Yes Fillable Fileable
Form and Instruction 3 Yes Yes Fillable Fileable

Health Health Care Services

 

216 0
   
Individuals or Households
 
   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 899 0 899 0 0 0
Annual IC Time Burden (Hours) 120 0 120 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment B: Training Materials 11/29/2018
Supporting Statement 11/29/2018
Cover Letter 11/29/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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