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Psychiatric Hospital Survey Report Form

IC 112905 under ICR 198301-0938-006 · OMB 0938-0104.

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Information Collection (IC) Details

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PSYCHIATRIC HOSPITAL SURVEY REPORT FORM
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-1537A No No
Form 1514 No No


    

240 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested 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 240 0 0 240 0 0
Annual IC Time Burden (Hours) 2,880 0 0 2,880 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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