EHR Pharmacy Residence Informaticists Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0036 can be found here:

Documents and Forms

Document Name Document Type
Form OMB 0917-0036-0031 EHR Pharmacy Residence Informaticists Survey Form and Instruction
OMB 0917-0036-0031 OMB 0917-0036-0031, EHR Pharmacy Resident Informaticist OMB 0917-0036-31, EHR_Pharmacy_Resident_InformaticistCourse-2014.pdf www.surveymonkey.com/s/TF2BXL3 Form and Instruction
OMB No 0917-0036-31 Pharmacy Residency Informatics Rotation Survey.doc OMB No. 0917-0036-0031, Mini-Supporting Statemen forEHR Pharmacy Resident Informaticist Rotation Survey IC Document

Information Collection (IC) Details

IC Title:	EHR Pharmacy Residence Informaticists Survey	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	OMB 0917-0036-0031	OMB 0917-0036-0031, EHR Pharmacy Resident Informaticist Survey	OMB 0917-0036-31, EHR_Pharmacy_Resident_InformaticistCourse-2014.pdf	https://www.surveymonkey.com/s/TF2BXL3	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 17	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	34	34
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB No. 0917-0036-0031, Mini-Supporting Statemen forEHR Pharmacy Resident Informaticist Rotation Survey	OMB No 0917-0036-31 Pharmacy Residency Informatics Rotation Survey.doc	03/04/2014

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