NAMCS-201 Community Health Center Induction Interview (Line 2)

National Ambulatory Medical Care Survey

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0234 can be found here:

Documents and Forms

Document Name Document Type
Form 2 NAMCS-201 Community Health Center Induction Interview (Line 2) Form and Instruction
2 NAMCS-201 Community Health Center Induction Interview (L NAMCS 10-12 OMB ATT N.pdf Form and Instruction
NAMCS 09-12 Attachment G.pdf Att. G. Induction Instructions IC Document

Information Collection (IC) Details

IC Title:	NAMCS-201 Community Health Center Induction Interview (Line 2)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	2	NAMCS-201 Community Health Center Induction Interview (Line 2)	NAMCS 10-12 OMB ATT N.pdf		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0167 Health Resources Utilization Statistics	FR Citation: 49 FR 37693

Number of Respondents: 104	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 %

	Approved	Previously Approved
Annual Number of Responses for this IC	104	104
Annual IC Time Burden (Hours)	35	35
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att. G. Induction Instructions	NAMCS 09-12 Attachment G.pdf	06/04/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.