Information Collection

State Medical Board Directors Follow-up Questions to the November 1, 2018 Training

IC 234569 under ICR 201710-0910-006 · OMB 0910-0697.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0697 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Survey - Board of Medicine Directors.docx	Other-Survey
All Board Execs and Contact Info.xlsx	Other-List of Contacts
0697 OMB Approval Memo - Medical Board Directors 2019.doc OMB Memo	IC Document

IC Title:

State Medical Board Directors Follow-up Questions to the November 1, 2018 Training

Agency IC Tracking Number:

ORA

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
Other-Survey			Survey - Board of Medicine Directors.docx		Yes	No	Paper Only
Other-List of Contacts			All Board Execs and Contact Info.xlsx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	50	50
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo	0697 OMB Approval Memo - Medical Board Directors 2019.doc	01/28/2019

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