OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

MMP Short Facility Survey

IC 245511 under ICR 202012-0920-020 · OMB 0920-1340.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

MMP Short Facility Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Medical Monitoring Project Short Facility Survey (screenshots) Att 7 MMP short facility survey screenshots.docx Yes Yes Fillable Fileable
Form and Instruction n/a MMP Short Facility Survey (Word version) Att 6 MMP short facility survey instrument final_edited.docx No   Paper Only

Health Health Care Services

 

225 0
   
Private Sector Businesses or other for-profits
 
   90 %

  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 225 0 225 0 0 0
Annual IC Time Burden (Hours) 19 0 19 0 0 0
Annual IC Cost Burden (Dollars) 659 0 659 0 0 0

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.