Information Collection

NAMCS Feasibility Study

IC 211558 under ICR 201205-0920-001 · OMB 0920-0222.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

NAMCS Feasibility Study

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.