Information Collection

42 CFR 2.22 Notice to Patients of Federal Confidentiality Requirements

IC 7502 under ICR 202301-0930-005 · OMB 0930-0092.

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IC Title:

42 CFR 2.22 Notice to Patients of Federal Confidentiality Requirements

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 2.22 Notice to Patients

Information Collection Instruments:

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Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13,585

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,658,729	1,658,729
Annual IC Time Burden (Hours)	331,746	331,746
Annual IC Cost Burden (Dollars)	15,923,798	15,923,798

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