Att D_Phone Script

National Ambulatory Medical Care Survey Supplement on Culturally and Linguistically Appropriate Services (NAMCS CLAS)

Documents and Forms

Document Name Document Type
Att D - Phone Script 4Apr16.docx Other-WORD

Information Collection (IC) Details

IC Title:	Att D_Phone Script	Agency IC Tracking Number:	15BCU

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			Att D - Phone Script 4Apr16.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0167 Health Resources Utilization Statistics	FR Citation: 49 FR 37697

Number of Respondents: 912	Number of Respondents for Small Entity: 128

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 4 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	912	912
Annual IC Time Burden (Hours)	76	76
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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