Obtaining Supplemental Information from Hospital or Doctor

Obtaining Supplemental Information from Hospital or Doctor

OMB: 2900-0121

IC ID: 28336

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Document Type
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Information Collection (IC) Details

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Obtaining Supplemental Information from Hospital or Doctor
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 29-551B No No


    

244 0
   
Individuals or Households
 
   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 244 0 0 0 0 244
Annual IC Time Burden (Hours) 61 0 0 0 0 61
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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