NAMCS Feasibility Study

NCHS Questionnaire Design Research Laboratory

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Document Name Document Type
NAMCS Feasibility Study Form and Instruction
Physician Survey 0920-0222_Attach 1 - NAMCS Physician Survey_3 072214.docx Form and Instruction
Medical Organization Survey 0920-0222_Attach 2 - NAMCS Medical Organization Survey3 072214.docx Form and Instruction
Phys and Organization Survey 0920-0222_Attach 3 - NAMCS Physician and Medical Organization Survey3 072214.docx Form and Instruction
0920-0222 QDRL Physician Feasibility 072414.docx Supporting Statement IC Document
0920-0222 Attach 4 - NAMCS Feasibility Advance Letters.docx Letters IC Document

Information Collection (IC) Details

IC Title:	NAMCS Feasibility Study	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	none	Physician Survey	0920-0222_Attach 1 - NAMCS Physician Survey_3 072214.docx	Yes	Yes	Fillable Fileable
Form and Instruction	none	Medical Organization Survey	0920-0222_Attach 2 - NAMCS Medical Organization Survey3 072214.docx	Yes	Yes	Fillable Fileable
Form and Instruction	none	Phys and Organization Survey	0920-0222_Attach 3 - NAMCS Physician and Medical Organization Survey3 072214.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,268	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,268	2,268
Annual IC Time Burden (Hours)	779	779
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	0920-0222 QDRL Physician Feasibility 072414.docx	07/25/2014
Letters	0920-0222 Attach 4 - NAMCS Feasibility Advance Letters.docx	07/25/2014

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