Information Collection

Primary Care Resident Physicians

IC 197527 under ICR 201111-0925-001 · OMB 0925-0635.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Survey 1 for Residents (Pre-Survey) Primary Care Resident Physicians	Form
Form 1 Residents Post Survey 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
1 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:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	1				Yes	Yes	Fillable Printable
Form	1				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	Previously Approved
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		04/26/2011
Attachment A13 End of Study Email Residents in Control Group 4-7-11sh		04/26/2011

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

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