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Physicians/Medical Secretaries
The Healthy Communities Study: How Communities Shape Childrens Health (NHLBI)
OMB: 0925-0649
IC ID: 199554
OMB.report
HHS/NIH
OMB 0925-0649
ICR 201201-0925-002
IC 199554
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0649 can be found here:
2013-07-24 - Revision of a currently approved collection
2013-02-28 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Physicians/Medical Secretaries
Form and Instruction
1 record Retrieval Protocol
HCS_SSA_ATTACH 19_RECORD RETRIEVAL PROTOCOL_SEPTEMBER 2011 FINAL for OMB.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Physicians/Medical Secretaries
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 and Instruction
1
record Retrieval Protocol
HCS_SSA_ATTACH 19_RECORD RETRIEVAL PROTOCOL_SEPTEMBER 2011 FINAL for OMB.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,750
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
4,750
0
4,750
0
0
0
Annual IC Time Burden (Hours)
808
0
808
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.