Information Collection

NASA TREAT Astronauts Act

IC 235920 under ICR 202306-2700-002 · OMB 2700-0171.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2700-0171 2023 TREAT Astronaut Act screenshots (1).docx Electronic Medical Records System	Other-System screenshots
2700-0171 2023 TREAT Astronaut Act screenshots (1).docx Electronic Medical Records System	Other-System screenshots
2700-0171 TREAT Astronaut Act text.docx Electronic Medical Records System	Other-System text
2700-0171 TREAT Astronaut Act text.docx Electronic Medical Records System	Other-System text
nasa_10hims.docx 10 Health Information Management Systems	IC Document
nasa_10hims.docx 10 Health Information Management Systems	IC Document

IC Title:

Agency IC Tracking Number:

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-System screenshots			2700-0171 2023 TREAT Astronaut Act screenshots (1).docx	Electronic Medical Records System	Yes	Yes	Fillable Fileable
Other-System text			2700-0171 TREAT Astronaut Act text.docx	Electronic Medical Records System	Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title: Health Information Management System 10 HIMS

FR Citation: 86 FR 71097

Number of Respondents: 175

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	175	175
Annual IC Time Burden (Hours)	88	88
Annual IC Cost Burden (Dollars)	4,375	4,375

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
10 Health Information Management Systems	nasa_10hims.docx	05/13/2019

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