National ART Surveillance System

Assisted Reproductive Technology (ART) Program Reporting System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0556 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0556 National ART Surveillance System Form
National ART Surveillance System Att C1a. (Current thru 2015) NASS Screens.pdf Form
0920-0556 (15BGk) Att C1b v2 (Proposed) Future NASS screens for 2016 Att C1b v2 (Proposed) Future NASS screens for 2016_09 04 2015.docx Form
0920-0556 National ART Surveillance System NASS 2.) (Proposed for Att. C1b_v3 (Proposed) Future NASS screens for 2017.docx Form
Att C2. (Current) NASS Annual Submission Instructions.doc NASS Instructions IC Document
Att C3. (Current) NASS Users Manual.pdf NASS User manual IC Document
Att C6. Detailed List of NASS Changes_07 08 2015.docx Att C6. Detailed List of NASS Changes_07 08 2015 IC Document
0920-0556 Change Request Justification_09-16-2015.docx 0920-0556 Change Request Justification_09-16-2015 IC Document
0920-0556 Change Request Justification_08-01-2016.docx Change Request Justification IC Document

Information Collection (IC) Details

IC Title:	National ART Surveillance System	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-0556	National ART Surveillance System NASS 2.) (Proposed for 2016)	Att. C1b_v3 (Proposed) Future NASS screens for 2017.docx	Yes	Yes	Fillable Printable
Form	none	National ART Surveillance System	Att C1a. (Current thru 2015) NASS Screens.pdf	Yes	Yes	Fillable Fileable
Form	0920-0556 (15BGk)	Att C1b v2 (Proposed) Future NASS screens for 2016	Att C1b v2 (Proposed) Future NASS screens for 2016_09 04 2015.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 447	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	157,791	157,791
Annual IC Time Burden (Hours)	110,454	110,454
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NASS Instructions	Att C2. (Current) NASS Annual Submission Instructions.doc	02/12/2015
NASS User manual	Att C3. (Current) NASS Users Manual.pdf	02/12/2015
Att C6. Detailed List of NASS Changes_07 08 2015	Att C6. Detailed List of NASS Changes_07 08 2015.docx	10/07/2015
0920-0556 Change Request Justification_09-16-2015	0920-0556 Change Request Justification_09-16-2015.docx	10/07/2015
Change Request Justification	0920-0556 Change Request Justification_08-01-2016.docx	08/11/2016

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