Information Collection

New Burden from Rulemaking (Third-Party Disclosure) - Transfer/provision of copies of mammograms and records upon patient's request-900.12(c)(4)(ii) and (c)(4)(iii)

IC 235524 under ICR 201903-0910-026 · OMB 0910-0309.

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Information Collection (IC) Details

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IC Title:	New Burden from Rulemaking (Third-Party Disclosure) - Transfer/provision of copies of mammograms and records upon patient's request-900.12(c)(4)(ii) and (c)(4)(iii)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 900.12

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8,691	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 95 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	13,106,028	13,106,028
Annual IC Time Burden (Hours)	1,048,482	1,048,482
Annual IC Cost Burden (Dollars)	0	0

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