Information Collection

Women's Reproductive Health Care Provider Survey (WRHCPS)

IC 265770 under ICR 202403-0720-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Provider Survey Draft 01.22.2024.docx	Other-Survey Instrument
0720-WHRS Survey 08.20.2024_FINAL.docx	Other-Survey Instrument

IC Title:

Agency IC Tracking Number:

0720-WRHS

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
Other-Survey Instrument			0720-WHRS Survey 08.20.2024_FINAL.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,129

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,129	2,129
Annual IC Time Burden (Hours)	710	710
Annual IC Cost Burden (Dollars)	37,676	37,676

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.