OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

NAMCS Provider Facility Interview (PFI) (Survey year: 2025 & 2027)

IC 256553 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)

NAMCS Provider Facility Interview (PFI) (Survey year: 2025 & 2027)
 
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 Provider Facility Interview (PFI)_10JAN2025 Attachment L_NAMCS Provider Facility Interview.docx N/A Yes Yes Fillable Fileable

Health Public Health Monitoring

 

3,000 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 3,000 0 -18,667 0 0 21,667
Annual IC Time Burden (Hours) 2,250 0 -8,584 0 0 10,834
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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