Bureau of Primary Health Care Patient Survey

Bureau of Primary Health Care Patient Survey

OMB: 0915-0326

IC ID: 188365

Information Collection (IC) Details

View Information Collection (IC)

Bureau of Primary Health Care Patient Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 001-BPHC Patient Survey BPHC Patient Survey Instrument Attachment 2 - Survey Instrument - 02-12-09.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

5,773 0
   
Private Sector Not-for-profit institutions
 
   100 %

  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 5,773 0 5,773 0 0 0
Annual IC Time Burden (Hours) 7,218 0 7,218 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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