Information Collection

NPDB HIPDB Users Group Reporting Survey

IC 182579 under ICR 200711-0915-001 · OMB 0915-0316.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form users group report NPDB HIPDB Users Group Reporting Survey	Form
users group report users group reporting survey users group reporting survey.doc	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	users group reporting survey	users group reporting survey	users group reporting survey.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,302

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,302	2,302
Annual IC Time Burden (Hours)	576	576
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.