Information Collection

National Practitioner Data Bank Call Center Customer Satisfaction Survey

IC 242662 under ICR 201506-0915-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 National Practitioner Data Bank Call Center Customer Satisfaction Survey	Form
1 NPDB Customer Survey Questions.docx NPDB Customer Survey Questions.docx	Form
NPDB OMB Supporting Statement FINAL.docx Supporting Statement	IC Document

IC Title:

National Practitioner Data Bank Call Center Customer Satisfaction Survey

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	NPDB Customer Survey Questions.docx	NPDB Customer Survey Questions.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	1,440	1,440
Annual IC Time Burden (Hours)	360	360
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	NPDB OMB Supporting Statement FINAL.docx	07/13/2020

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