User Non-User Survey

Survey of Eligible Users of the National Practitioner Databank

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0366 can be found here:

Documents and Forms

Document Name Document Type
Form 2 User Non-User Survey Form and Instruction
2 User Non-User Survey User_Nonuser_Survey.docx Form and Instruction

Information Collection (IC) Details

IC Title:	User Non-User Survey	Agency IC Tracking Number:

Is this a Common Form? No		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	2	User Non-User Survey	User_Nonuser_Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15,200	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15,200	15,200
Annual IC Time Burden (Hours)	4,817	4,817
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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