AIRS Emergency Department Visits Reporting

Asthma Information Reporting System (AIRS)

OMB: 0920-0853

IC ID: 220722

Information Collection (IC) Details

View Information Collection (IC)

AIRS Emergency Department Visits Reporting
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0853 STATE [Year] Emergency Department Data Att3b_AIRS ED Visits Reporting Form.xlsx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

25 0
   
State, Local, and Tribal Governments
 
   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 25 0 2 0 0 23
Annual IC Time Burden (Hours) 13 0 1 0 0 12
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Instructions for Asthma State Awardees Att3d1_AIRS Instructions_HD_ED_Data_clean.docx 04/04/2019
Att eb1. AIRS ED Visits Reporting Example Att3b1_AIRS ED Visits Reporting Example.xlsx 04/04/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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