2019 Traditional Provider Induction Interview (NAMCS-1)

National Ambulatory Medical Care Survey (NAMCS)

OMB: 0920-0234

IC ID: 220059

Information Collection (IC) Details

View Information Collection (IC)

2019 Traditional Provider Induction Interview (NAMCS-1)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none 2019 NAMCS-1 Questions for Traditional Physicians Att C1-2019 NAMCS 1 TradPhys 012519.docx Yes Yes Fillable Fileable
Instruction Att C3-2019 Induction Sample Card TradPhy.docx Yes Yes Fillable Fileable
Form none Sample 2019 Patient Record Att F-2019 Patient Record Form (NAMCS-73).pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

Human Resources Utilization 09-20-0167  49 FR 37697

1,097 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved 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 1,097 0 863 0 0 234
Annual IC Time Burden (Hours) 549 0 432 0 0 117
Annual IC Cost Burden (Dollars) 17,640 0 17,640 0 0 0

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

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