Data Dictionary- Hospitalizations

[NCEH] Environmental Public Health Tracking Network (Tracking Network)

Documents and Forms

Document Name Document Type
Form 0920-1175 Data Dictionary- Hospitalizations Form and Instruction
0920-1175 Data Dictionary- Hospitalizations Att4E Hospitalization Form.docx Form and Instruction
0920-1175 Data Dictionary- Hospitalizations Att4E Hospitalization Form.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Data Dictionary- Hospitalizations	Agency IC Tracking Number:	0920-1175

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

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	0920-1175	Data Dictionary- Hospitalizations	Att4E Hospitalization Form.docx		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 37	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	37	7	30
Annual IC Time Burden (Hours)	1,480	-920	2,400
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.