NAMCS-1 Physician Induction Interview (Line 1)

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⚠️ Notice: This information collection may be referencing outdated material.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
NAMCS-1 Physician Induction Interview (Line 1) Form
National Ambulatory Medical Care Survey Panel 2011 Att F 2011 namcs-1.pdf Form
Att G Changes to NAMCS-1 and NAMCS-201 Items for Survey Year 2012.pdf Att G - Changes to NAMCS-1 and NAMCS-201 for 2012 IC Document
Att C CAM.PDF Att C - CAM questions IC Document
Att D CAM definitions.pdf Att D - CAM definitions IC Document

Information Collection (IC) Details

IC Title:	NAMCS-1 Physician Induction Interview (Line 1)	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	National Ambulatory Medical Care Survey Panel 2011	Att F 2011 namcs-1.pdf		Yes	Yes	Fillable Fileable

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: 16,237	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	16,237	11,225	5,012
Annual IC Time Burden (Hours)	9,472	7,133	2,339
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Att G - Changes to NAMCS-1 and NAMCS-201 for 2012	Att G Changes to NAMCS-1 and NAMCS-201 Items for Survey Year 2012.pdf	11/07/2011
Att C - CAM questions	Att C CAM.PDF	11/07/2011
Att D - CAM definitions	Att D CAM definitions.pdf	11/07/2011

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