Information Collection

Award Fee Provider Survey

IC 194123 under ICR 201710-0720-001 · OMB 0720-0048.

Documents and Forms

Document Name Document Type
TRICARE Provider SatSurvey _TeleInstrument 19May17.doc Other-Telesurvey Script

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Award Fee Provider Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-Telesurvey Script			TRICARE Provider SatSurvey _TeleInstrument 19May17.doc		No		Printable Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,224	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,224	0	1,224
Annual IC Time Burden (Hours)	102	0	102
Annual IC Cost Burden (Dollars)	4,415	1,473	2,942

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.