List of all ICR documents

IC Title	Form Name
340B Program Registrations & Certifications for Disproportionate Share Hospitals	340B Registration DSH-Revised Cert state or local government-Revised Public OWNERSHIP-Revised
340B Program Registrations & Certifications for Children's Hospitals	340B Registration Children's Hospital-Revised Cert state or local government Revised Public OWNERSHIP Revised
Certification to Enroll DSH and Children's Hospitals' Outpatient facilities to 340B Program	340B Registration-Outpatient Facility-Revised
Hospital Annual Recertification	Hospital Recertification-DSH Recert-Critical Access; Sole-community; Rural-Referral centers (Orphan Drug) Recert-Free standing Cancer Hospital (Orphan Drug)-Revised
340B Registration for all other covered entities	340BRegistration-Covered Entities – Community Health Center 340BRegistration-Covered Entities All Other-Revised 340BRegistration-Covered Entities STD-Revised 340BRegistration-Covered Entities TB-Revised
Annual Recertification for Family Planning	FP-Recert
Annual Recertification for STD & TB	STD-Recertification TB-Recertification
Annual Recertification for Other Entities	Community Health Center Recert RW-Recert
Administrative Change Form	340B Participant Change Request Revised
Contract Pharmacy Self Certification Form	Contract Pharmacy Registration-Revised Contract Pharmacy Termination
Administrative Changes for Any Manufacturer	340B Manufacturer Change Form-Revised
340B Program Registrations & Certifications for Free Standing Cancer Hospitals	340B Registration Free Standing Cancer-Revised
340B Program Registrations & Certifications for Rural Referral Hospitals	340B Registration Rural Referral Centers and Sole Community Hospitals (Orphan Drug)
340B Program Registrations & Certifications for Sole Community Hospitals	340B Registration Rural Referral Centers and Sole Community Hospitals (Orphan Drug)
340B Program Registrations and Certifications for Critical Access Hospitals	340B Registration-CAH Revised
Pharmaceutical Pricing Agreement	Manu-Pharma Pricing Agreement(PPA)
Manufacturer Data Required to Verify 340B Ceiling Price Calculations	Manufacturer Data Fields for 340B Ceiling Price