Information Collection

Ambulatory Unit Induction

IC 43613 under ICR 200808-0920-007 · OMB 0920-0278.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0278 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHAMCS-101/U Ambulatory Unit Induction	Form and Instruction
NHAMCS-101/U Ambulatory Unit Induction NHAMCS Att K 2009 Revised101u.pdf	Form and Instruction
NHAMCS Att K Cover sheet 2009x Revised101u (2).doc Cover Sheet	IC Document

IC Title:

Ambulatory Unit Induction

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NHAMCS-101/U	Ambulatory Unit Induction	NHAMCS Att K 2009 Revised101u.pdf		Yes	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Health Resources Utilization Statistics

FR Citation: 49 FR 37697

Number of Respondents: 845

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,690	1,235	455
Annual IC Time Burden (Hours)	1,690	1,500	190
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Cover Sheet	NHAMCS Att K Cover sheet 2009x Revised101u (2).doc	07/23/2008

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