Information Collection

OMB No. 0917-0036, Indian Health Service (IHS) RPMS Stakeholder Survey – Resource and Patient Management System Program Operational Analysis Needs Assessment

IC 211814 under ICR 201301-0917-001 · OMB 0917-0036.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

View Information Collection (IC)

IC Title:

OMB No. 0917-0036, Indian Health Service (IHS) RPMS Stakeholder Survey â Resource and Patient Management System Program Operational Analysis Needs Assessment

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	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 â Resource and Patient Management System Program Operational Analysis Needs Assessment	2014 RPMS User Survey FINAL DRAFT for OMB.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

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 %

table that charts list of burden
	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

table that charts IC Documents
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.