Information Collection

Att 4b_Exploratory Testing Guide_ Patient Centered Care

IC 223932 under ICR 202106-0920-013 · OMB 0920-1182.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att4b-Exp Guide-Patient-Centered Care.docx	Other-WORD
Att4b-Exp Guide-Patient-Centered Care.docx	Other-WORD

IC Title:

Agency IC Tracking Number:

0920-1182

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD					No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 95

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	95	95
Annual IC Time Burden (Hours)	95	95
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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