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Pre-Hospital Care Data - PCNASP Awardee -EMS respondents
Paul Coverdell National Acute Stroke Program (PCNASP) Reporting System
OMB: 0920-1108
IC ID: 236180
OMB.report
HHS/CDC
OMB 0920-1108
ICR 202001-0920-002
IC 236180
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1108 can be found here:
2022-01-18 - No material or nonsubstantive change to a currently approved collection
2021-04-27 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Pre hospital data elements_010720_clean.docx
Other-Data elements
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Pre-Hospital Care Data - PCNASP Awardee -EMS respondents
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Data elements
Pre hospital data elements_010720_clean.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
7
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
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
28
0
0
0
0
28
Annual IC Time Burden (Hours)
56
0
0
0
0
56
Annual IC Cost Burden (Dollars)
2,052
0
0
0
0
2,052
Documents for IC
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.