NHDS - Primary Procedure Hospitals Sample Listing Sheet

National Hospital Discharge Survey

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0212 can be found here:

Documents and Forms

Document Name Document Type
Attachment G 2 HDS sample listing sheet.pdf Other-Primary Procedures Hospitals S
Attachment G 2 Cover.doc Attachment G2 - cover sheet for hospitals sample listing sheet IC Document

Information Collection (IC) Details

IC Title:	NHDS - Primary Procedure Hospitals Sample Listing Sheet	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Primary Procedures Hospitals Sampling Listing Sheet			Attachment G 2 HDS sample listing sheet.pdf		No	No	Paper 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: 13	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 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	156	156
Annual IC Time Burden (Hours)	65	65
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment G2 - cover sheet for hospitals sample listing sheet	Attachment G 2 Cover.doc	07/24/2008

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