Information Collection Request

The Blue Button Connector

ICR 201406-0955-001 · OMB 0955-0016 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
0955_Section B Statistical Methods (3).doc Supporting Statement B Uploaded 2014-07-07 Available
CLEAN_Blue Connector Supporting Statement V9 (ROCIS).doc Supporting Statement A Uploaded 2014-09-12 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
213117 Application Developers Other-Survey New
213113 State Immunization Registries Other-Survey New
213112 Labs Other-Survey New
213111 Hospitals Other-Survey New
213110 Providers Other-Survey New
212254 State HIEs Other-Survey New
212253 Pharmacies Other-Survey New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2017 36 Months From Approved
2,742 0 0
138 0 0
0 0 0





Reginfo record details
7
table that charts list of burden
IC Title Form No. Form Name
Labs
State Immunization Registries
Application Developers
Pharmacies
State HIEs
Providers
Hospitals

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,742 0 0 2,742 0 0
Annual Time Burden (Hours) 138 0 0 138 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No