Information Collection

Physician Workflow Survey (line 8)

IC 196405 under ICR 201211-0920-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Physician Workflow Survey (line 8)	Form
E. Physician Workflow Survey Year 2013 (EHR adopters) Attachment E.docx	Form
F. Physician Workflow Survey Year 2013 (EHR nonadopters) Attachment F.docx	Form

IC Title:

Physician Workflow Survey (line 8)

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	E. Physician Workflow Survey Year 2013 (EHR adopters)	Attachment E.docx		Yes	No	Fillable Printable
Form	None	F. Physician Workflow Survey Year 2013 (EHR nonadopters)	Attachment F.docx		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title: Health Resources Utilization Statistics

FR Citation: 49 FR 37693

Number of Respondents: 2,645

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: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,645	2,645
Annual IC Time Burden (Hours)	1,323	1,323
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.