Information Collection

Health Center Workforce Survey

IC 255724 under ICR 202208-0906-003 · OMB 0906-0072.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Health Center Workforce Survey	Form and Instruction
1 English Spanish HRSA Health Center Workforce Survey 20220802 English_Spanish HRSA Health Center Workforce Survey V10_clean.docx	Form and Instruction
1 English Spanish HRSA Health Center Workforce Survey 20220802 English_Spanish HRSA Health Center Workforce Survey V10_clean.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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
Form and Instruction	1	English Spanish HRSA Health Center Workforce Survey	20220802 English_Spanish HRSA Health Center Workforce Survey V10_clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 450,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	450,000	450,000
Annual IC Time Burden (Hours)	225,000	225,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.