Information Collection

National Practitioner Data Bank Usability Survey

IC 264355 under ICR 202401-0915-004 · OMB 0915-0212.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 National Practitioner Data Bank Usability Survey	Form and Instruction
1 0915-0212_UsabiltyTesting Instrument_NPDBSystem 0915-0212_UsabiltyTesting Instrument_NPDBSystem.docx	Form and Instruction
1 0915-0212_UsabiltyTesting Instrument_NPDBSystem 0915-0212_UsabiltyTesting Instrument_NPDBSystem.docx	Form and Instruction
0915-0212_Fast track Memo (Updated).docx Original Generic Request	IC Document
0915-0212_Fast track Memo (Updated).docx Original Generic Request	IC Document

IC Title:

Agency IC Tracking Number:

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	0915-0212_UsabiltyTesting Instrument_NPDBSystem	0915-0212_UsabiltyTesting Instrument_NPDBSystem.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

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 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
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

table that charts IC Documents
Title	Document	Date Uploaded
Original Generic Request	0915-0212_Fast track Memo (Updated).docx	01/09/2024

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