DPDB Usability Surveys

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

IC Title:	DPDB Usability Surveys	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 %

	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

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.