Attachment 3 -- Evaluation Provider Interview

Clinical Decision Support (CDS) for Chronic Pain Management

OMB: 0935-0257

IC ID: 244078

Information Collection (IC) Details

View Information Collection (IC)

Attachment 3 -- Evaluation Provider Interview
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3 Attachment 3 -- Evaluation Provider Interview Attachment 3_Evaluation Provider Interview.docx Yes Yes Fillable Fileable

Health Health Care Services

 

10 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 10 0 10 0 0 0
Annual IC Time Burden (Hours) 5 0 5 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 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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