View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Evaluation Survey of Eligible National Practitioner Data Bank (NPDB) Entity Users: Relevance of Information Collected via NPDB Query Forms	Agency IC Tracking Number:

IC Status: New

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	1	User Survey Questions-Query FINAL For Clearance	User Survey Questions - Query_FINAL_For Clearance.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 900	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	900	0	900	0	0	0
Annual IC Time Burden (Hours)	150	0	150	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Query Survey Instructions	Query Survey Intro-Instructions - FINAL_For Clearance.docx	12/06/2023
OMB Fast Track Justification	OMB Fast Track Memo_Infostatica_Request for Approval_Query Survey FINAL_For Clearance.docx	12/06/2023

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