Information Collection

NAMCS-1 Physician Induction Interview (Line 1)

IC 43612 under ICR 201309-0920-004 · OMB 0920-0234.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0234 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NAMCS-1 Physician Induction Interview (Line 1)	Form
NAMCS-1 Induction Interview Attachment C1.pdf	Form
Attachemnt A3.docx A3 - Changes to Physician Workforce Questions	IC Document
Attachemnt A2.docx A2 - Changes to EHR Questions	IC Document
Attachment A1.docx A1 - Changes to Physician Induction Interview	IC Document
Attachment C2.docx C2 - Confidentiality Statement	IC Document

IC Title:

NAMCS-1 Physician Induction Interview (Line 1)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	none	NAMCS-1 Induction Interview	Attachment C1.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title: 09-20-0167 Health Resources Utilization Statistics

FR Citation: 49 FR 37693

Number of Respondents: 17,034

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	17,034	17,034
Annual IC Time Burden (Hours)	9,937	9,937
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
A3 - Changes to Physician Workforce Questions	Attachemnt A3.docx	09/04/2013
A2 - Changes to EHR Questions	Attachemnt A2.docx	09/04/2013
A1 - Changes to Physician Induction Interview	Attachment A1.docx	09/04/2013
C2 - Confidentiality Statement	Attachment C2.docx	09/04/2013

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