IHS Website ICD-10 Stakeholder Readiness Survey - ICD-10 Project Needs Assessment

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0036 can be found here:

Documents and Forms

Document Name Document Type
Form 0917-0036-27 IHS Website ICD-10 Stakeholder Readiness Survey - ICD-10 Project Needs Assessment Form and Instruction
0917-0036-27 OMB No. 0917-0036-27, IHS Website ICD-10 Stakeholder Rea OMB No. 0917-0036-27, IHS Website ICD-10 Stakeholder Readiness Survey - ICD-10 Project Needs Assessment.docx Form and Instruction
OMB No. 0917-0036-27, Mini-supporting Statement for IHS ICD-10 Readiness Survey.doc OMB No. 0917-0036-27 IC Document

Information Collection (IC) Details

IC Title:	IHS Website ICD-10 Stakeholder Readiness Survey - ICD-10 Project Needs Assessment	Agency IC Tracking Number:

IC Status: New

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 and Instruction	0917-0036-27	OMB No. 0917-0036-27, IHS Website ICD-10 Stakeholder Readiness Survey - ICD-10 Project Needs Assessment	OMB No. 0917-0036-27, IHS Website ICD-10 Stakeholder Readiness Survey - ICD-10 Project Needs Assessment.docx		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	83	83
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB No. 0917-0036-27	OMB No. 0917-0036-27, Mini-supporting Statement for IHS ICD-10 Readiness Survey.doc	10/24/2013

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