Information Collection

PCP Lecture Evaluation (Healthcare Professionals)

IC 237811 under ICR 202603-0925-001 · OMB 0925-0764.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Evaluation PCP Lecture Evaluation (Healthcare Professionals)	Form
1 Evaluation PCP Lecture Evaluation.docx	Form

IC Title:

Agency IC Tracking Number:

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: 09-25-0014 entitled Clinical Research: Student Records, HHS/NIH/OD/OIR/OE

FR Citation: 67 FR 60742

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,000	0	1,000
Annual IC Time Burden (Hours)	50	-33	83
Annual IC Cost Burden (Dollars)	0	0	0

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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