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NAMCS and NHAMCS Patient Record Evaluation
NCHS Questionnaire Design Research Laboratory
OMB: 0920-0222
IC ID: 194864
OMB.report
HHS/CDC
OMB 0920-0222
ICR 201002-0920-006
IC 194864
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:
2022-12-21 - Revision of a currently approved collection
2021-08-16 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
NAMCS and NHAMCS Patient Record Evaluation
Form
Patient Record Evaluation
NAMCS HNAMCS Attach 1.pdf
Form
NAMCS HNAMCS Attach 3 Invit letter.docx
Invitational Letter
IC Document
NAMCS NHAMCS Attach 2 -intro.doc
Introduction to Interview
IC Document
QDRL NAMCS & NHAMCS Evaluation-0930.doc
Justification Letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NAMCS and NHAMCS Patient Record Evaluation
Agency IC Tracking Number:
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
Form
none
Patient Record Evaluation
NAMCS HNAMCS Attach 1.pdf
No
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
20
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
20
0
0
0
0
0
Annual IC Time Burden (Hours)
20
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Invitational Letter
NAMCS HNAMCS Attach 3 Invit letter.docx
10/04/2010
Introduction to Interview
NAMCS NHAMCS Attach 2 -intro.doc
10/04/2010
Justification Letter
QDRL NAMCS & NHAMCS Evaluation-0930.doc
10/04/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.