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Account Creation and Profile Completion
Health Workforce Connector
OMB: 0906-0031
IC ID: 226284
OMB.report
HHS/HRSA
OMB 0906-0031
ICR 202010-0906-001
IC 226284
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0031 can be found here:
2023-09-08 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Account Creation and Profile Completion
Form and Instruction
1 Account Creation Instructions and Screenshots
Account Creation Instructions and Screenshots - Attachment D.docx
Form and Instruction
2 Account Creation Instructions and Screenshots
Profile Completion Instructions and Screenshots - Attachment E.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Account Creation and Profile Completion
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
Form and Instruction
1
Account Creation Instructions and Screenshots
Account Creation Instructions and Screenshots - Attachment D.docx
Yes
Yes
Fillable Fileable
Form and Instruction
2
Account Creation Instructions and Screenshots
Profile Completion Instructions and Screenshots - Attachment E.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
5,008
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
5,008
0
-10,592
0
0
15,600
Annual IC Time Burden (Hours)
4,565
0
-6,083
0
0
10,648
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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.