Health Care Providers

National Center for Complementary and Alternative Medicine (NCCAM) Communications Program Planning and Evaluation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0530 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Health Care Providers Form and Instruction
1 survey HCP survey instrument revised 3 24.docx Form and Instruction
cover memo 0530.doc cover memo 0530 IC Document
gc form 0530.doc gc form 0530 IC Document

Information Collection (IC) Details

IC Title:	Health Care Providers	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	survey	HCP survey instrument revised 3 24.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	400	0	0	0	0	0
Annual IC Time Burden (Hours)	20	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
cover memo 0530	cover memo 0530.doc	04/08/2009
gc form 0530	gc form 0530.doc	04/08/2009

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