OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Joes

IC 271546 under ICR 202501-0720-001 · OMB 0720-0085.

Documents and Forms
Document Name
Document Type
Other-Survey
Other-Survey
Other-Survey
Other-Survey
Other-Survey
Other-Survey
Information Collection (IC) Details

View Information Collection (IC)

JOES 0720-JOES
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey JOES-7 Questionnaire 10-3-2024.docx Yes Yes Fillable Fileable
Other-Survey JOES-C Questionnaire_Revised_10.3.2024.docx Yes Yes Fillable Fileable
Other-Survey JOES-Ambulatory Survey_10.4.2024.docx Yes Yes Fillable Fileable
Other-Survey JOES-Dental Survey_10.4.2024.docx Yes Yes Fillable Fileable
Other-Survey JOES-Emergency Department Survey_10.4.2024.docx Yes Yes Fillable Fileable
Other-Survey JOES-Walk-in Contraceptive Clinic Survey_10.4.2024.docx Yes Yes Fillable Fileable

Health Health Care Services

Joint Outpatient Experience  89 FR 56347

310,000 0
   
Individuals or Households
 
   70 %

  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 310,000 0 310,000 0 0 0
Annual IC Time Burden (Hours) 26,533 0 26,533 0 0 0
Annual IC Cost Burden (Dollars) 834,250 0 834,250 0 0 0

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.