HRSA Division of Practitioner Data Bank (DPDB) 2019 Education Forum Participant Survey

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

OMB: 0915-0212

IC ID: 235410

Information Collection (IC) Details

View Information Collection (IC)

HRSA Division of Practitioner Data Bank (DPDB) 2019 Education Forum Participant Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 2019 NPDB Education Forum Feedback Survey.pdf 2019 NPDB Education Forum Feedback Survey.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

150 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 150 0 150 0 0 0
Annual IC Time Burden (Hours) 3 0 3 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A SSA Generic Clearance_DPDB_NPDB 2019 Education Forum.docx 03/19/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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