OMB
.report
Search
Survey of Physician Practices in Laboratory Test Ordering and Interpretation
Quantitative Survey of Physician Practices in Laboratory Test Ordering and Interpretation
OMB: 0920-0893
IC ID: 197773
OMB.report
HHS/CDC
OMB 0920-0893
ICR 201110-0920-009
IC 197773
( )
Documents and Forms
Document Name
Document Type
Survey of Physician Practices in Laboratory Test Ordering and Interpretation
Form
Survey of Physician Practices
CDC Questionnaire 10-17-2011.pdf
Form
Attachment D Advance letter.doc
Attachment D - Advance letter
IC Document
Attachment E Email invite.docx
Attachment E - Email invitation
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Survey of Physician Practices in Laboratory Test Ordering and Interpretation
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
none
Survey of Physician Practices
CDC Questionnaire 10-17-2011.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,600
Number of Respondents for Small Entity:
570
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
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
1,600
0
0
0
0
1,600
Annual IC Time Burden (Hours)
373
0
0
0
0
373
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment D - Advance letter
Attachment D Advance letter.doc
05/09/2011
Attachment E - Email invitation
Attachment E Email invite.docx
05/09/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.