Information Collection

Healthcare News Subscriber Survey

IC 218154 under ICR 201305-0920-009 · OMB 0920-0974.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0974 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0974 15BES Healthcare News Subscriber Survey	Form and Instruction
0920-0974 15BES 03__Screen Shots of Healthcare News Subscriber Survey up 03__Screen Shots of Healthcare News Subscriber Survey updated 09-09-2015.pdf	Form and Instruction
01__Request for Approval Form v2015-08-17.docx 01__Request for Approval Form	IC Document
02__Invitation to participate 2015-08-14.docx 02__Invitation to participate 2	IC Document

IC Title:

Healthcare News Subscriber Survey

Agency IC Tracking Number:

15BES

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	0920-0974 15BES	03__Screen Shots of Healthcare News Subscriber Survey updated 09-09-2015	03__Screen Shots of Healthcare News Subscriber Survey updated 09-09-2015.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 31,500

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	31,500	31,500
Annual IC Time Burden (Hours)	5,250	5,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
01__Request for Approval Form	01__Request for Approval Form v2015-08-17.docx	09/10/2015
02__Invitation to participate 2	02__Invitation to participate 2015-08-14.docx	09/10/2015

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