Information Collection

National Practitioner Data Bank Usability Survey

IC 264355 under ICR 202406-0906-005 · OMB 0906-0084.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0084 can be found here:

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
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:

National Practitioner Data Bank Usability Survey

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	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	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

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.