Information Collection

NIDDK Health Care Provider Satisfaction Survey

IC 260105 under ICR 202307-0925-002 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NIDDK Health Care Provider Satisfaction Survey	Form and Instruction
1 Survey OCHIN Web Survey screenshots.pdf	Form and Instruction
Template Survey-Request-for-Approval_OCHIN-HCP_updated.docx Template	IC Document

IC Title:

NIDDK Health Care Provider Satisfaction Survey

Agency IC Tracking Number:

IC Status: Unchanged

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	Survey	OCHIN Web Survey screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Template	Template Survey-Request-for-Approval_OCHIN-HCP_updated.docx	05/15/2023

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