INSTITUTIONALIZATION OF FAMILY MEDICINE

ICR 198004-0935-002

OMB: 0935-0038

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
112103
Migrated
ICR Details
0935-0038 198004-0935-002
Historical Active
HHS/AHRQ
INSTITUTIONALIZATION OF FAMILY MEDICINE
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 05/22/1980
Retrieve Notice of Action (NOA) 04/17/1980
  Inventory as of this Action Requested Previously Approved
12/31/1980 12/31/1980
125 0 0
63 0 0
0 0 0

THE DATA GATHERING WILL PROVIDE BASELINE INFORMATION IN DETERMINING THE "INSTITUTIONALIZATION" OF FAMILY MEDICINE UNITS WHICH WILL BE USEFUL IN EFFECTIVELY AWARDING AND MONITORING FAMILY MEDICINE GRANTS.

None
None


No

1
IC Title Form No. Form Name
INSTITUTIONALIZATION OF FAMILY MEDICINE

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 125 0 0 0 125 0
Annual Time Burden (Hours) 63 0 0 0 63 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/17/1980


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