Disease Classification

Stem Cell Therapeutic Outcomes Database

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0310 can be found here:

Documents and Forms

Document Name Document Type
Form 2 Disease Classification Form
2 Form 2402 R5.pdf Disease Classification Form 2402 R5.pdf Form
2 Form 2402 R5.pdf Disease Classification Form 2402 R5.pdf Form
2-2 Draft 2402 R6.docx Disease Classification 2 Draft 2402 R6.docx Form
2-2 Draft 2402 R6.docx Disease Classification 2 Draft 2402 R6.docx Form
03.11.2020 Disease Classification Form 2402 Proposed Changes.docx Proposed Changes to Form IC Document
03.11.2020 Disease Classification Form 2402 Proposed Changes.docx Proposed Changes to Form IC Document

Information Collection (IC) Details

IC Title:	Disease Classification	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	2	Form 2402 R5.pdf Disease Classification	Form 2402 R5.pdf		Yes	Yes	Fillable Fileable
Form	2-2	Draft 2402 R6.docx Disease Classification 2	Draft 2402 R6.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	9,600	9,600
Annual IC Time Burden (Hours)	4,160	4,160
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Proposed Changes to Form	03.11.2020 Disease Classification Form 2402 Proposed Changes.docx	03/16/2020

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