Information Collection Request

Health Workforce Connector

ICR 202309-0906-001 · OMB 0906-0031 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 2 Profile Completion Instructions and Screenshots Form New Repair queued
Form 1 Account Creation Form Modified Missing upstream
BMISS Privacy Impact Assessment - Attachment F.pdf Supplementary Document Uploaded 2023-09-08 Missing upstream
Section 336A(6) of the PHS Act - Attachment C.pdf Supplementary Document Uploaded 2023-09-08 Repair queued
Section 336(f) of the PHS Act - Attachment B.pdf Supplementary Document Uploaded 2023-09-08 Repair queued
Section 333(d) of the PHS Act - Attachment A.pdf Supplementary Document Uploaded 2023-09-08 Missing upstream
Health Workforce Connector Supporting Statement - FINAL - 8.3.23.docx Supporting Statement A Uploaded 2023-09-08 Missing upstream

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
262088 Profile Completion Instructions and Screenshots Form New
226284 Account Creation Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 12/31/2023
9,172 5,008
4,565 4,565
0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Account Creation 1 Account Creation
Profile Completion Instructions and Screenshots 2 Profile Completion

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 9,172 5,008 0 4,164 0 0
Annual Time Burden (Hours) 4,565 4,565 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No