View Information Collection (IC)

View Information Collection (IC)

MPC Contact Guide/Screening Call
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Attachment 72 Attachment 72 – MPC Hospital Contact Guide Attachment 72 – MPC Hospital Contact Guide.docx Yes Yes Fillable Fileable
Form and Instruction Attachment 73 Attachment 73 – MPC Office-Based Doctor Contact Guide Attachment 73 – MPC Office-Based Doctor Contact Guide.docx Yes Yes Fillable Fileable
Form and Instruction Attachment 74 Attachment 74 – MPC Home Care Contact Attachment 74 – MPC Home Care Contact Guide.docx Yes Yes Fillable Fileable
Form and Instruction Attachment 75 Attachment 75 – MPC Institution Contact Guide Attachment 75 – MPC Institution Contact Guide.docx Yes Yes Fillable Fileable
Form and Instruction Attachment 76 Attachment 76 – MPC Pharmacy Contact Guide Attachment 76 – MPC Pharmacy Contact Guide.docx Yes Yes Fillable Fileable
Form and Instruction Attachment 77 Attachment 77 – MPC Separate Billing Doctor Contact Guide Attachment 77 – MPC Separate Billing Doctor Contact Guide.docx Yes Yes Fillable Fileable

Health Immunization Management

 

36,598 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 36,598 0 0 0 0 36,598
Annual IC Time Burden (Hours) 1,220 0 0 0 0 1,220
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.