Information Collection

Primary Care Resident Physicians

IC 197527 under ICR 201104-0925-004 · OMB 0925-0635.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0635 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 Primary Care Resident Physicians	Form
1 Survey 1 for Residents (Pre-Survey) 7 - Attachment B2-3 Survey 1 for Residents (Pre Survey) 2-28-11 sh.docx	Form
2 Residents Post Survey Attachment B2-4 Survey 2 for Residents (Post Survey) 3-30-11 sh[1].docx	Form
Attachment A2 Email Invitation to Residents 3-30-11 sh.docx Attachment A2 Email Invitation to Residents 3-30-11 sh	IC Document
Attachment A13 End of Study Email Residents in Control Group 4-7-11sh.docx Attachment A13 End of Study Email Residents in Control Group 4-7-11sh	IC Document

IC Title:

Primary Care Resident Physicians

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	2	Residents Post Survey	Attachment B2-4 Survey 2 for Residents (Post Survey) 3-30-11 sh[1].docx		Yes	Yes	Fillable Printable
Form	1	Survey 1 for Residents (Pre-Survey)	7 - Attachment B2-3 Survey 1 for Residents (Pre Survey) 2-28-11 sh.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 308

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	616	616
Annual IC Time Burden (Hours)	105	105
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment A2 Email Invitation to Residents 3-30-11 sh	Attachment A2 Email Invitation to Residents 3-30-11 sh.docx	04/26/2011
Attachment A13 End of Study Email Residents in Control Group 4-7-11sh	Attachment A13 End of Study Email Residents in Control Group 4-7-11sh.docx	04/26/2011

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