OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Chiropractic and Pharmacy Loan Repayment- Survey of Clinic Medical Directors

IC 178406 under ICR 200701-0915-004 · OMB 0915-0306.

Documents and Forms
Document Name
Document Type
Form
Form
Form
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Chiropractic and Pharmacy Loan Repayment- Survey of Clinic Medical Directors
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form Survey of Clinic Medical Directors- Pharm Survey of Clinic Medical Directors- Pharm Tab C- MedDirs Survey-Pharm.doc No No Paper Only
Form Survey of Clinic Medical Directors - Chiro Survey of Clinic Medical Directors- Chiro Tab C- Medical Directors Survey-Chiropractic.doc No No Paper Only

Health Public Health Monitoring

 

60 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 60 0 60 0 0 0
Annual IC Time Burden (Hours) 30 0 30 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Cover Letter to Medical Directors- Demo Clinics Tab C- Cover Letter Demonstration clinics.doc 08/02/2006
Cover Letter to Medical Directors- Comparison Clinics Tab C- Cover Letter Comparison Clinics.doc 08/02/2006
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.