Information Collection

RANDS (Round 3) during COVID-19

IC 245515 under ICR 202102-0920-004 · OMB 0920-1323.

Documents and Forms

Document Name Document Type
RANDS (Round 3) during COVID-19 Form and Instruction
Web Questionnaire Introduction Screen / Telephone Interv Att B - Intro Screen and Questionnaire_01 28 2021.docx Form and Instruction
Web Questionnaire Introduction Screen / Telephone Interv Att B - Intro Screen and Questionnaire_01 28 2021.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	RANDS (Round 3) during COVID-19	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	NA	Web Questionnaire Introduction Screen / Telephone Interview Introduction / RANDS during COVID-19 Questionnaire	Att B - Intro Screen and Questionnaire_01 28 2021.docx	N/A	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: 5,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,200	5,200
Annual IC Time Burden (Hours)	1,733	1,733
Annual IC Cost Burden (Dollars)	0	0

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.