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NAMCS-201 Community Health Center Induction Interview (Line 2)
National Ambulatory Medical Care Survey
OMB: 0920-0234
IC ID: 181889
OMB.report
HHS/CDC
OMB 0920-0234
ICR 201111-0920-001
IC 181889
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0234 can be found here:
2022-10-21 - Revision of a currently approved collection
2021-06-01 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
NAMCS-201 Community Health Center Induction Interview (Line 2)
Form
Att K - Community Health Center Induction Interview
Att K Community Health Center Induction Interview 2011.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
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
none
Att K - Community Health Center Induction Interview
Att K Community Health Center Induction Interview 2011.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
09-20-0167 Health Resources Utilization Statistics
FR Citation:
49 FR 37693
Number of Respondents:
2,008
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:
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
2,008
0
1,904
0
0
104
Annual IC Time Burden (Hours)
669
0
634
0
0
35
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.