Information Collection

Generic Survey Clearance of the EHR Impact Data Base

IC 42682 under ICR 199907-3145-005 · OMB 3145-0136.

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Information Collection (IC) Details

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IC Title:	Generic Survey Clearance of the EHR Impact Data Base	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 26,412	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 9 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	35,962	10	35,952
Annual IC Time Burden (Hours)	29,880	100	29,780
Annual IC Cost Burden (Dollars)	532,000	7,000	525,000

Documents for IC

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