Information Collection

Healthcare Workforce Survey

IC 264049 under ICR 202309-0915-002 · OMB 0915-0396.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Healthcare Workforce Survey Healthcare Workforce Survey	Form and Instruction
1 Healthcare Workforce Survey 1. Healthcare Workforce Screener and Survey 12192023.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				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 29,359

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	29,359	29,359
Annual IC Time Burden (Hours)	7,340	7,340
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.

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