PRETEST FOR A NATIONAL SURVEY OF AMBULATORY SURGERY

ICR 199206-0920-004

OMB: 0920-0305

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
111040
Migrated
ICR Details
0920-0305 199206-0920-004
Historical Active
HHS/CDC
PRETEST FOR A NATIONAL SURVEY OF AMBULATORY SURGERY
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/09/1992
Retrieve Notice of Action (NOA) 06/16/1992
  Inventory as of this Action Requested Previously Approved
06/30/1993 06/30/1993
1,427 0 0
305 0 0
0 0 0

THE PURPOSE OF THIS PRETEST IS TO FIELD TEST (IN SELECTED HOSPITALS AN FREESTANDING AMBULATORY SURGERY CENTERS) ALL PROCEDURES, MANUALS, FORM INSTRUCTIONS, TRAINING, AND DATA COLLECTION METHODS DEVELOPED FOR THE NATIONAL SURVEY OF AMBULATORY SURGERY.

None
None


No

1
IC Title Form No. Form Name
PRETEST FOR A NATIONAL SURVEY OF AMBULATORY SURGERY

  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 1,427 0 0 1,427 0 0
Annual Time Burden (Hours) 305 0 0 305 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
06/16/1992


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