Information Collection

Medical Assistants Change in Practice Survey

IC 220408 under ICR 202102-0920-003 · OMB 0920-1129.

Documents and Forms

Document Name Document Type
Medical Assistants Change in Practice Survey Form
Medical Assistants Change in Practice Survey P7 Medical Assistants Change in Practice Survey.pdf Form
Medical Assistants Change in Practice Survey P7 Medical Assistants Change in Practice Survey.pdf Form
F7 Medical Assistants Change in Practice Survey.docx Medical Assistants Change in Practice Survey - word IC Document
F7 Medical Assistants Change in Practice Survey.docx Medical Assistants Change in Practice Survey - word IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medical Assistants Change in Practice Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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
Form	none	Medical Assistants Change in Practice Survey	P7 Medical Assistants Change in Practice Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-250	250
Annual IC Time Burden (Hours)	-63	63
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Medical Assistants Change in Practice Survey - word	F7 Medical Assistants Change in Practice Survey.docx	03/02/2016

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