Information Collection

Medical Arts Branch (MAB) Services Survey

IC 226868 under ICR 201501-0925-004 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Medical Arts Branch (MAB) Services Survey	Form and Instruction
051017-Final-PRA-Letter-Medical Arts Branch Survey.docx	Other-Email
1 Medical Arts Branch Survey 051017-Final-FY17 Medical Arts Branch Survey.docx	Form and Instruction
051017-DRAFT-Medical Arts Branch Request for OMB Survey Approval.docx Medical Arts Branch (MAB) Services Survey	IC Document

IC Title:

Medical Arts Branch (MAB) Services Survey

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	1	Medical Arts Branch Survey	051017-Final-FY17 Medical Arts Branch Survey.docx		Yes	Yes	Fillable Fileable
Other-Email			051017-Final-PRA-Letter-Medical Arts Branch Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

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	100	100
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Medical Arts Branch (MAB) Services Survey	051017-DRAFT-Medical Arts Branch Request for OMB Survey Approval.docx	05/16/2017

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