Form 1 Query Survey Intro-Instructions

OMB No: 0915-0212

Expiration Date: 4/30/2024

Entity Users Survey Instructions – Query

The National Practitioner Data Bank Short Survey

Thank you for your participation in this survey. Please note that the National Practitioner Data Bank will be referred to as the NPDB throughout the survey. This survey primarily focuses on NPDB queries, and the term “practitioner” consistently refers to health care practitioners.

The survey takes 5 to 10 minutes to complete. If you aren't directly responsible for querying practitioners, we kindly ask that the individual overseeing querying within your organization completes this survey.

You do not have to complete all of it in one sitting. If at any time during the survey you wish to exit and return to complete the survey at a later time, your responses will be automatically saved. By clicking on the link provided in the invitation letter, you will be returned to the section of the survey where you exited. Once you submit the survey, you will not be able to retake the survey, and the link provided will cease to provide access to the survey.

Please use the navigation buttons at the bottom of each page of the survey to move through each section of the survey or to access previous pages to change responses.

Warning! Do not use your Internet browser’s “back”, “forward”, “stop”, or “reload/refresh” buttons for navigation while taking this survey. This may cause the survey to lose track of the page that you are on and may invalidate your responses or prevent you from continuing the survey.

Your responses will be confidential. The data will be used for improving the NPDB. Please click the navigation button below to continue.

Public Burden Statement: The purpose of this survey is to evaluate NPDB query forms to determine whether there is a need to collect new information or discontinue collecting information that is not useful. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this information collection is 0915-0212 and it is valid until 4/30/2024. This information collection is voluntary. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Information Collection Clearance Officer, 5600 Fishers Lane, Room 14N39, Rockville, Maryland, 20857 or [email protected].