OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Evaluation of the Electronic Health Records Demonstration (Office System Survey)

IC 191859 under ICR 201002-0938-006 · OMB 0938-1072.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Evaluation of the Electronic Health Records Demonstration (Office System Survey)
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10273 Office System Survey EHRD-OMB OSS w ARRA questions.pdf Yes Yes Paper Only

Health Health Care Services

 

2,500 0
   
Private Sector Businesses or other for-profits
 
   90 %

  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 500 0 0 0 0 500
Annual IC Time Burden (Hours) 240 0 0 0 0 240
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.