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National Survey of Prison Health Care Interview Guide
National Survey of Prison Health Care (NSPHC)
OMB: 0920-0935
IC ID: 202389
OMB.report
HHS/CDC
OMB 0920-0935
ICR 201205-0920-007
IC 202389
( )
Documents and Forms
Document Name
Document Type
National Survey of Prison Health Care Interview Guide
Form
NSPHC Interview Guide
Attachment F NSPHC Interview Guide.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Survey of Prison Health Care Interview Guide
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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
NSPHC Interview Guide
Attachment F NSPHC Interview Guide.doc
No
No
Paper Only
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:
51
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
51
0
51
0
0
0
Annual IC Time Burden (Hours)
204
0
204
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.