OMB No. 0917-0036, Indian Health Service (IHS) RPMS Stakeholder Survey – Resource and Patient Management System Program Operational Analysis 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⚠️ Notice: This information collection may be referencing outdated material.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 OMB No. 0917-0036, Indian Health Service (IHS) RPMS Stakeholder Survey – Resource and Patient Management System Program Operational Analysis Needs Assessment Form and Instruction
0917-0036 OMB No. 0917-0036, Indian Health Service (IHS) RPMS Stak 2014 RPMS User Survey FINAL DRAFT for OMB.docx Form and Instruction
OMB No 0917-0036 Mini-Supporting Statement for IHS RPMS Stakeholder Survey -43.doc OMB No. 0917-0036, Mini-Supporting Statement for IHS RPMS Stakeholder Survey - 43 IC Document

Information Collection (IC) Details

IC Title:	OMB No. 0917-0036, Indian Health Service (IHS) RPMS Stakeholder Survey – Resource and Patient Management System Program Operational Analysis Needs Assessment	Agency IC Tracking Number:	43

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	OMB No. 0917-0036, Indian Health Service (IHS) RPMS Stakeholder Survey – Resource and Patient Management System Program Operational Analysis Needs Assessment	2014 RPMS User Survey FINAL DRAFT for OMB.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	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	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, Mini-Supporting Statement for IHS RPMS Stakeholder Survey - 43	OMB No 0917-0036 Mini-Supporting Statement for IHS RPMS Stakeholder Survey -43.doc	06/09/2014

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