Information Collection

Main Study

IC 204491 under ICR 201210-0910-001 · OMB 0910-0730.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
HCP Survey_Appendix B_Main Study Survey.docx	Other-Survey
HCP Survey_Appendix C_Main Study EmailsReminders.doc HCP Survey_Appendix C_Main Study EmailsReminders	IC Document

IC Title:

Main Study

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
Other-Survey			HCP Survey_Appendix B_Main Study Survey.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	600	600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
HCP Survey_Appendix C_Main Study EmailsReminders	HCP Survey_Appendix C_Main Study EmailsReminders.doc	02/05/2013

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