Information Collection

Social Work and Family Physicians 6 Month Follow-Up

IC 245668 under ICR 202102-0920-003 · OMB 0920-1129.

Documents and Forms

Document Name Document Type
Form 0920-1129 Social Work and Family Physicians 6 Month Follow-Up Form and Instruction
0920-1129 B16 Social Work & Family Physicians Pre-Training SurveyW B16 Social Work & Family Physicians Pre-Training Survey_Web-based version.pdf Form and Instruction
0920-1129 B16 Social Work & Family Physicians Pre-Training SurveyW B16 Social Work & Family Physicians Pre-Training Survey_Web-based version.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Social Work and Family Physicians 6 Month Follow-Up	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 241

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1129	B16 Social Work & Family Physicians Pre-Training SurveyWeb-based version	B16 Social Work & Family Physicians Pre-Training Survey_Web-based version.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,167	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,167	1,167
Annual IC Time Burden (Hours)	156	156
Annual IC Cost Burden (Dollars)	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.