OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

(ACPI) Providers and their Proxies (Survey year: 2026)

IC 247675 under ICR 202412-0920-002 · OMB 0920-0234.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

(ACPI) Providers and their Proxies (Survey year: 2026)
 
Yes Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0234 NAMCS Provider Facility Interview (PFI) Attachment L_NAMCS Provider Facility Interview.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0234 NAMCS Ambulatory Care Provider Interview (ACPI) Providers and their Proxies_10JAN2025 Attachment D_ACPI_Provider.docx N/A Yes Yes Fillable Fileable

Health Public Health Monitoring

 

3,333 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,333 0 333 0 0 3,000
Annual IC Time Burden (Hours) 833 0 -1,417 0 0 2,250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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