Information Collection

Conditions for Coverage for Rural Health Clinics -- (New RHC Mid Level Practitioner)

IC 190716 under ICR 200909-0938-005 · OMB 0938-0334.

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IC Title:

Conditions for Coverage for Rural Health Clinics -- (New RHC Mid Level Practitioner)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 491.9 42 CFR 491.10 42 CFR 491.11

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

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 199

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	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	199	199
Annual IC Time Burden (Hours)	1,990	1,990
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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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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