(ACPI) Providers and their Proxies (Survey year: 2026)

National Ambulatory Medical Care Survey (NAMCS)

Documents and Forms

Document Name Document Type
Form 0920-0234 (ACPI) Providers and their Proxies (Survey year: 2026) Form and Instruction
0920-0234 NAMCS Provider Facility Interview (PFI) Attachment L_NAMCS Provider Facility Interview.docx Form and Instruction

Information Collection (IC) Details

IC Title:	(ACPI) Providers and their Proxies (Survey year: 2026)	Agency IC Tracking Number:	0920-2034

Is this a Common Form? Yes		IC Status: Modified

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	0920-0234	NAMCS Provider Facility Interview (PFI)	Attachment L_NAMCS Provider Facility Interview.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,333	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,333	333	3,000
Annual IC Time Burden (Hours)	1,667	-583	2,250
Annual IC Cost Burden (Dollars)	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.