Information Collection

NAMCS-1 Physician Induction Interview (Line 1)

IC 43612 under ICR 201111-0920-001 · OMB 0920-0234.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.