OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Clinician - Clinician Survey

IC 272978 under ICR 202603-0920-005 · OMB 0920-1459.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Clinician - Clinician Survey 0920-26-0130
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction N/A Clinician Survey Att C_Clinician Survey_V10_Clean.docx N/A No   Fillable Fileable
Form and Instruction 0920-26-0130 Clinican Survey Att C_Clinician Survey_Karna_clean.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

200 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 200 0 0 0 0 200
Annual IC Time Burden (Hours) 33 0 0 0 0 33
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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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