OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Electronic Medical Record Data Collection

IC 193533 under ICR 201007-0935-001 · OMB 0935-0168.

Documents and Forms
Document Name
Document Type
Other-List of variables extracted
Information Collection (IC) Details

View Information Collection (IC)

Electronic Medical Record Data Collection
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-List of variables extracted Attachment B -- Electronic Medical Record Data Collection.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

2 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 104 0 104 0 0 0
Annual IC Time Burden (Hours) 1,040 0 1,040 0 0 0
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.