Pfi (2023- 2025)

National Ambulatory Medical Care Survey (NAMCS)

Documents and Forms

Document Name Document Type
Form 0920-0234 PFI (2023- 2025) Form and Instruction
0920-0234 PFI (2023-2025) Attachment E2_Draft NAMCS Provider Facility Interview.docx Form and Instruction
0920-0234 PFI (2023-2025) Attachment E2_Draft NAMCS Provider Facility Interview.docx Form and Instruction

Information Collection (IC) Details

IC Title:	PFI (2023- 2025)	Agency IC Tracking Number:	0920-2034

Is this a Common Form? No		IC Status: Modified

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	0920-0234	PFI (2023-2025)	Attachment E2_Draft NAMCS Provider Facility Interview.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,000	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,000	1,000	2,000
Annual IC Time Burden (Hours)	2,250	750	1,500
Annual IC Cost Burden (Dollars)	0	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.