Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Evaluation Survey of Eligible National Practitioner Data Bank (NPDB) Entity Users: Relevance of Information Collected via NPDB Report Forms New 159 33 0 Form and Instruction 2 Adverse Action Reports Module
Form and Instruction 5 Closing Questions
Form and Instruction 4 Judgment or Conviction Reports Module
Form and Instruction 3 Medical Malpractice Payment Reports Module
Form and Instruction 1 Opening Questions
Instruction
HRSA Health Center Workforce Survey: Cognitive Interviews New 60 90 0 Form 1 Cognitive Interview Informed Consent
HRSA Health Center Workforce Survey: Pilot Survey New 400 300 0 Form and Instruction 2 HRSA Survey Draft
Form 1 Informed Consent
Health Center Community Engagement Network (CEN) – New Applicant Toolkit Project New 18 36 0 Instruction
Health Center Community Engagement Network (CEN) – New Applicant Toolkit Project- Group 2 New 9 18 0 Form and Instruction 1 Facilitator Guide - New Applicant Toolkit (Part 2)
Health Center Community Engagement Network (CEN)- Financial Sustainability AG New 320 320 0 Form and Instruction 1 CEN Financial Facilitator Guide
Health Center Workforce Survey: Listening Sessions New 60 120 0 Other-Slide Deck
Form 1 Listening Session Consent Form
Interviews with National Hypertension Control Initiative (NHCI) Group 2 Participants New 120 120 0 Instruction
Morgan State University Maternal Health Equity Coordinating Center (MSU MHECC) Feedback Forms New 120 20 0 Form and Instruction 1 Collaborators Feedback Form
Form and Instruction 2 Faculty Training Feedback Form
Form and Instruction 3 Operations Partner Feedback Form
Form and Instruction 4 Student Training Feedback Form
National Organ Donation Expert Opinion Survey for Information Dissemination New 18 6 0 Form and Instruction 1 Final Report Stakeholder Contact Language
Organ Procurement and Transplantation Network (OPTN) Stakeholder Focus Groups New 100 100 0 Instruction
PRA Questions for CEN Groups New 80 320 0 Instruction
Primary Care and Behavioral Health Integration (PCBHI) Training Follow Up Discussion New 64 96 0 Instruction
Usability Testing for HRSA.gov website properties New 200 100 0 Instruction
Instruction
ealth Center Workforce Survey Evaluation and Technical Assistance: Pilot Survey New 300 150 0 Form 1 Survey
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 2028 1829 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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