Information Collection

Evaluation Survey of Eligible National Practitioner Data Bank (NPDB) Entity Users: Relevance of Information Collected via NPDB Query Forms

IC 263816 under ICR 202401-0915-001 · OMB 0915-0212.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Evaluation Survey of Eligible National Practitioner Data Bank (NPDB) Entity Users: Relevance of Information Collected via NPDB Query Forms	Form and Instruction
Form 1 Evaluation Survey of Eligible National Practitioner Data Bank (NPDB) Entity Users: Relevance of Information Collected via NPDB Query Forms	Form and Instruction
1 User Survey Questions-Query FINAL For Clearance User Survey Questions - Query_FINAL_For Clearance.docx	Form and Instruction
1 User Survey Questions-Query FINAL For Clearance User Survey Questions - Query_FINAL_For Clearance.docx	Form and Instruction
Query Survey Intro-Instructions - FINAL_For Clearance.docx Query Survey Instructions	IC Document
Query Survey Intro-Instructions - FINAL_For Clearance.docx Query Survey Instructions	IC Document
OMB Fast Track Memo_Infostatica_Request for Approval_Query Survey FINAL_For Clearance.docx OMB Fast Track Justification	IC Document
OMB Fast Track Memo_Infostatica_Request for Approval_Query Survey FINAL_For Clearance.docx OMB Fast Track Justification	IC Document
Introductory message from NPDB FINAL_For Clearance.docx Introductory message from NPDB FINAL	IC Document
Introductory message from NPDB FINAL_For Clearance.docx Introductory message from NPDB FINAL	IC Document
NonSubstantive Change Request.docx Non Substantive Change Request	IC Document
NonSubstantive Change Request.docx Non Substantive Change Request	IC Document

IC Title:

Evaluation Survey of Eligible National Practitioner Data Bank (NPDB) Entity Users: Relevance of Information Collected via NPDB Query Forms

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	User Survey Questions-Query FINAL For Clearance	User Survey Questions - Query_FINAL_For Clearance.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 900

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	900	900
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Query Survey Instructions	Query Survey Intro-Instructions - FINAL_For Clearance.docx	12/06/2023
OMB Fast Track Justification	OMB Fast Track Memo_Infostatica_Request for Approval_Query Survey FINAL_For Clearance.docx	12/06/2023
Introductory message from NPDB FINAL	Introductory message from NPDB FINAL_For Clearance.docx	12/14/2023
Non Substantive Change Request	NonSubstantive Change Request.docx	12/14/2023

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