Uniform Data System

HRSA Uniform Data System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0193 can be found here:

Documents and Forms

Document Name Document Type
Form 1R Uniform Data System Form and Instruction
1R 0193 2019 UDS Tables (redline).docx 0193 2019 UDS Tables (redline) 12.19.18.docx Form and Instruction
1C 0193 2019 UDS Tables (clean).docx 0193 2019 UDS Tables (clean) 12.19.18.docx Form and Instruction
0193 2019 UDS Manual (redline) 12.21.18.docx UDS Manual Redline IC Document
0193 2019 UDS Manual (clean) 12.21.18.docx UDS Manual Clean IC Document

Information Collection (IC) Details

IC Title:	Uniform Data System	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 51c 42 CFR 56 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1R	0193 2019 UDS Tables (redline).docx	0193 2019 UDS Tables (redline) 12.19.18.docx		Yes	Yes	Fillable Fileable
Form and Instruction	1C	0193 2019 UDS Tables (clean).docx	0193 2019 UDS Tables (clean) 12.19.18.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,043	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,043	68	1,975
Annual IC Time Burden (Hours)	344,807	87,095	257,712
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
UDS Manual Redline	0193 2019 UDS Manual (redline) 12.21.18.docx	01/28/2019
UDS Manual Clean	0193 2019 UDS Manual (clean) 12.21.18.docx	01/28/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.