National Practitioner Data Bank (NPDB) Usability Survey

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Document Name Document Type
Form 1 National Practitioner Data Bank (NPDB) Usability Survey Form and Instruction
Form 1 National Practitioner Data Bank (NPDB) Usability Survey Form and Instruction
1 National Practitioner Data Bank (NPDB) Usability Survey 0915-0212_UsabiltyTesting Instrument_NPDBSystem.docx Form and Instruction
1 National Practitioner Data Bank (NPDB) Usability Survey 0915-0212_UsabiltyTesting Instrument_NPDBSystem.docx Form and Instruction
0915-0212_Fast track Memo (Updated).docx Fast Track Memo IC Document
0915-0212_Fast track Memo (Updated).docx Fast Track Memo IC Document

Information Collection (IC) Details

IC Title:	National Practitioner Data Bank (NPDB) Usability Survey	Agency IC Tracking Number:

IC Status: Unchanged

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	1	National Practitioner Data Bank (NPDB) Usability Survey	0915-0212_UsabiltyTesting Instrument_NPDBSystem.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Memo	0915-0212_Fast track Memo (Updated).docx	11/03/2023

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