Information Collection

Physician Induction Inverview (NAMCS-1)

IC 213881 under ICR 201702-0920-007 · OMB 0920-0234.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0234 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0234 Physician Induction Inverview (NAMCS-1)	Form and Instruction
0920-0234 Att C2 - 2016 NAMCS 1 TradPhys Att C2 - 2016 NAMCS 1 TradPhys 122115.docx	Form and Instruction
Att C3 - 2015 NAMCS 1 ListQ.DOCX List Q	IC Document
Att C3- 2016 NAMCS 1 CHC 122115.docx Att C3- 2016 NAMCS 1 CHC Proposed Changes	IC Document

IC Title:

Physician Induction Inverview (NAMCS-1)

Agency IC Tracking Number:

17QY

Is this a Common Form? No

IC Status: Modified

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	0920-0234	Att C2 - 2016 NAMCS 1 TradPhys	Att C2 - 2016 NAMCS 1 TradPhys 122115.docx		Yes	No	Fillable Printable

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 37693

Number of Respondents: 1,665

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,665	-925	2,590
Annual IC Time Burden (Hours)	1,249	-694	1,943
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
List Q	Att C3 - 2015 NAMCS 1 ListQ.DOCX	12/12/2014
Att C3- 2016 NAMCS 1 CHC Proposed Changes	Att C3- 2016 NAMCS 1 CHC 122115.docx	02/10/2016

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