Information Collection

Physician Induction Interview (2020)

IC 213881 under ICR 202210-0920-012 · OMB 0920-0234.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0234 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0234 Physician Induction Interview (2020)	Form and Instruction
0920-0234 Att P2- 2021 Census Reinterview Instrument Att P2- 2021 Census Reinterview Instrument.docx	Form and Instruction
0920-0234 Att P2- 2021 Census Reinterview Instrument Att P2- 2021 Census Reinterview Instrument.docx	Form and Instruction

IC Title:

Physician Induction Interview (2020)

Agency IC Tracking Number:

0920-0234

Is this a Common Form? No

IC Status: Removed

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
Form and Instruction	0920-0234	Att P2- 2021 Census Reinterview Instrument	Att P2- 2021 Census Reinterview Instrument.docx		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: 500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-500	500
Annual IC Time Burden (Hours)	-250	250
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.