Uniform Data System

Uniform Data System

OMB: 0915-0193

IC ID: 6420

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Uniform Data System
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 51c 42 CFR 56  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 UDS Manual UDS Manual 2012 V 25 with proposed 2013 changesCDHN.doc Yes Yes Fillable Fileable
Form and Instruction T7 T7 T7.doc Yes Yes Fillable Fileable
Form and Instruction T6A T6A T6A.doc Yes Yes Fillable Fileable
Form and Instruction App D App D APPENDIX D 2012_ELCD 92513.docx Yes Yes Fillable Fileable
Form and Instruction T4 T4 T4.doc Yes Yes Fillable Fileable
Form and Instruction T6B T6B T6B.doc Yes Yes Fillable Fileable
Form and Instruction 1 2014 Tables UDSTables2014_draft.docx Yes Yes Fillable Fileable
Form and Instruction 2 EHR Question EHR Ques ATTACHMENT 121113.docx Yes Yes Fillable Fileable

Health Health Care Services

 

1,287 0
   
Private Sector 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 1,287 0 0 0 0 1,287
Annual IC Time Burden (Hours) 111,438 0 0 0 0 111,438
Annual IC Cost Burden (Dollars) 254,826 0 0 0 0 254,826

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