Information Collection

DPDB Usability Surveys

IC 217730 under ICR 201502-0915-002 · OMB 0915-0212.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 DPDB Usability Surveys	Form
Website Key User Tasks and Scenarios- Instruction.docx	Instruction
1 NPDB System Form NPDB System Form.docx	Form
2 NPDB Website Form NPDB Website Form.docx	Form
Hospital Registration Initial Screenshot Supplemental.pdf Hospital Registration Initial Screenshot Supplemental	IC Document
RevisedDPDBUsabilityStudySupportingStatement (3).docx RevisedDPDBUsabilityStudySupportingStatement	IC Document

IC Title:

DPDB Usability Surveys

Agency IC Tracking Number:

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	Available Electronically?	Electronic Capability
Form	1	NPDB System Form	NPDB System Form.docx	No	Paper Only
Form	2	NPDB Website Form	NPDB Website Form.docx	No	Paper Only
Instruction			Website Key User Tasks and Scenarios- Instruction.docx	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	300	300
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Hospital Registration Initial Screenshot Supplemental	Hospital Registration Initial Screenshot Supplemental.pdf	07/31/2015
RevisedDPDBUsabilityStudySupportingStatement	RevisedDPDBUsabilityStudySupportingStatement (3).docx	07/31/2015

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