Information Collection

National Electronic Health Records Survey (nehrs)

IC 227139 under ICR 201911-0920-005 · OMB 0920-1015.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1015 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NATIONAL ELECTRONIC HEALTH RECORDS SURVEY (NEHRS)	Form and Instruction
2018 NEHRS Questionnaire Att B - 2018 NEHRS Questionnaire 061418.pdf	Form and Instruction
CATI Option for the 2018 NEHRS Questionnaire Att C - 2018 NEHRS CATI Script 061418.docx	Form and Instruction

IC Title:

NATIONAL ELECTRONIC HEALTH RECORDS SURVEY (NEHRS)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	n/a	2018 NEHRS Questionnaire	Att B - 2018 NEHRS Questionnaire 061418.pdf		No		Paper Only
Form and Instruction	n/a	CATI Option for the 2018 NEHRS Questionnaire	Att C - 2018 NEHRS CATI Script 061418.docx		Yes	Yes	Fillable Fileable

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: 10,302

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 30 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10,302	10,302
Annual IC Time Burden (Hours)	5,151	5,151
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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