NSRCF - Resident Questionnaire

National Survey of Residential Care Facilities (NSRCF) 2008-2010

OMB: 0920-0780

IC ID: 183891

Documents and Forms
Document Name
Document Type
Other-WORD
Information Collection (IC) Details

View Information Collection (IC)

NSRCF - Resident Questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Attachment K-Resident Questionnaire.doc Yes Yes Fillable Printable

Health Public Health Monitoring

Health Resources Utilization Statistics  49 FR 37697

1,125 300
   
Private Sector Businesses or other for-profits, 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 4,500 0 3,750 0 0 750
Annual IC Time Burden (Hours) 1,500 0 1,375 0 0 125
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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