Information Collection

TRICARE: Standard Survey of Civilian Providers

IC 5609 under ICR 202509-0720-002 · OMB 0720-0031.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
TSS_P FY25 web survey.pdf	Other-Survey
TSS_P FY25 web survey.pdf	Other-Survey
TSS_P_FY25 CATI script.docx	Other-Phone Version of Survey
TSS_P_FY25 CATI script.docx	Other-Phone Version of Survey
TSS-P 25 BH.pdf	Other-Behavioral Health Provider Sur
TSS-P 25 BH.pdf	Other-Behavioral Health Provider Sur
TSS-P 25 BH2.pdf	Other-Behavioral Health Provider Sur
TSS-P 25 BH2.pdf	Other-Behavioral Health Provider Sur
TSS-P 25 PC.pdf	Other-PC Survey Invitation
TSS-P 25 PC.pdf	Other-PC Survey Invitation
TSS-P 25 PC2.pdf	Other-Behavioral Health Provider Sur
TSS-P 25 PC2.pdf	Other-Behavioral Health Provider Sur

IC Title:

Agency IC Tracking Number:

0720-0031

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	Yes	Yes	Fillable Fileable
Other-Phone Version of Survey	No		Fillable Fileable
Other-Behavioral Health Provider Survey Invitation	Yes	Yes	Fillable Fileable
Other-Behavioral Health Provider Survey Reminder	Yes	Yes	Fillable Fileable
Other-PC Survey Invitation	Yes	Yes	Fillable Fileable
Other-Behavioral Health Provider Survey Reminder	Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 7,700

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 29 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,700	7,700
Annual IC Time Burden (Hours)	642	642
Annual IC Cost Burden (Dollars)	32,340	32,340

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.

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