Patient Flow Time Study

Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery: IHS Customer Service Satisfaction and Similar Surveys

Documents and Forms

Document Name Document Type
Form 0917-0036 Patient Flow Time Study Form and Instruction
0917-0036 Patient Flow Time Study OMB No. 0917-0036-33, Time Study_Patient Flow_.docx Form and Instruction
0917-0036 Patient Flow Time Study OMB No. 0917-0036-33, Time Study_Patient Flow_.docx Form and Instruction
OMB No. 0917-0036-33, Mini-Supporting Statement for Patient Flow.doc OMB No. 0917-0036, Mini-Supporting Statement fo Patient Flow Time Study IC Document
OMB No. 0917-0036-33, Mini-Supporting Statement for Patient Flow.doc OMB No. 0917-0036, Mini-Supporting Statement fo Patient Flow Time Study IC Document

Information Collection (IC) Details

IC Title:	Patient Flow Time Study	Agency IC Tracking Number:	33

IC Status: Unchanged

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	0917-0036	Patient Flow Time Study	OMB No. 0917-0036-33, Time Study_Patient Flow_.docx		No		Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 540	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	540	540
Annual IC Time Burden (Hours)	45	45
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB No. 0917-0036, Mini-Supporting Statement fo Patient Flow Time Study	OMB No. 0917-0036-33, Mini-Supporting Statement for Patient Flow.doc	05/08/2015

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