OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Health Information National Trends Survey

IC 215033 under ICR 201608-0925-002 · OMB 0925-0538.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Health Information National Trends Survey
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 B1- Instrument in English B1 - Instrument in English.docx Yes Yes Fillable Fileable

Health Health Care Services

 

4,318 0
   
Individuals or Households
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 -4,318 0 0 4,318
Annual IC Time Burden (Hours) 0 0 -2,159 0 0 2,159
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
B2 Instrument in Spanish B2 - Instrument in Spanish.docx 02/18/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.