The Healthcare Workforce Fielding Tracker

Evaluation of Programs Supporting the Mental Health of the Health Professions Workforce

Documents and Forms

Document Name Document Type
Form 1A The Healthcare Workforce Fielding Tracker Form and Instruction
1A Fielding Tracker 1A. The Healthcare Workforce Fielding Tracker_6.5.23_clean.xlsx Form and Instruction

Information Collection (IC) Details

IC Title:	The Healthcare Workforce Fielding Tracker	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1A	Fielding Tracker	1A. The Healthcare Workforce Fielding Tracker_6.5.23_clean.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 44	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	44	44
Annual IC Time Burden (Hours)	176	176
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.