TRICARE: Standard Survey of Civilian Providers

TRICARE: Select Survey of Civilian Providers

OMB: 0720-0031

IC ID: 5609

Information Collection (IC) Details

View Information Collection (IC)

TRICARE: Standard Survey of Civilian Providers
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Physician Survey 0720-0031_TSS-P 2019 Mailing Instrument - Physicians_10.15.2018.docx http://www.health.mil/healthsurveys Yes Yes Fillable Fileable
Other-Mental Health Provider Survey 0720-0031_TSS-P 2019 Mailing Instrument - Behavioral Health_10.15.2018.docx http://www.health.mil/healthsurveys Yes Yes Fillable Fileable
Other-Telephone Script 0720-0031_TSS-P 2019 Telephone Script_10.15.2018.docx http://www.health.mil/healthsurveys No   Paper Only
Other-Internet Survey 0720-0031_TSS-P 2019 Internet Survey_10.15.2018.docx http://www.health.mil/healthsurveys Yes Yes Fillable Fileable
Other-Internet Survey Screenshots 0720-0031_TSS-P 2019 Internet Survey Screenshots_10.15.2018.docx http://www.health.mil/healthsurveys Yes Yes Fillable Fileable

Defense and National Security Operational Defense

 

20,000 0
   
Individuals or Households
 
   8 %

  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 20,000 0 0 -30,000 0 50,000
Annual IC Time Burden (Hours) 1,667 0 0 -2,500 0 4,167
Annual IC Cost Burden (Dollars) 48,000 0 0 -72,000 0 120,000

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

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