View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

TRICARE: Standard Survey of Civilian Providers
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Physician Survey http://www.health.mil/healthsurveys Yes Yes Fillable Fileable
Other-Mental Health Provider Survey http://www.health.mil/healthsurveys Yes Yes Fillable Fileable
Other-Telephone Script No   Paper Only
Other-Internet Survey http://www.health.mil/healthsurveys Yes Yes Fillable Fileable
Other-Internet Survey Screenshots http://www.health.mil/healthsurveys Yes Yes Fillable Fileable

Defense and National Security Operational Defense

 

50,000 0
   
Individuals or Households
 
   18 %

  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 50,000 0 30,000 0 0 20,000
Annual IC Time Burden (Hours) 4,167 0 2,500 0 0 1,667
Annual IC Cost Burden (Dollars) 139,958 0 91,958 0 0 48,000

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