Order for Health Services

IHS Contract Health Service Report

OMB: 0917-0002

IC ID: 6559

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Order for Health Services
 
No Removed
 
Required to Obtain or Retain Benefits
 
42 CFR 136.24

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction IHS-843-1A Order for Health Services IHS-843-1A -Order for Health Services-Rev-June2009.pdf Yes Yes Fillable Printable

Health Health Care Services

 

7,424 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 -378,624 0 0 378,624
Annual IC Time Burden (Hours) 0 0 -18,931 0 0 18,931
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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