Information Collection

Evaluation Survey of Eligible National Practitioner Data Bank Entity Users: Relevance of Information Collected via NPDB Query Forms

IC 264354 under ICR 202608-0906-005 · OMB 0906-0084.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Query Survey Intro-Instructions Evaluation Survey of Eligible National Practitioner Data Bank Entity Users: Relevance of Information Collected via NPDB Query Forms	Form and Instruction
Form 2 User Survey Questions - Query Evaluation Survey of Eligible National Practitioner Data Bank Entity Users: Relevance of Information Collected via NPDB Query Forms	Form and Instruction
1 Query Survey Intro-Instructions Query Survey Intro-Instructions - FINAL_For Clearance.docx	Form and Instruction
2 User Survey Questions - Query User Survey Questions - Query_FINAL_For Clearance.docx	Form and Instruction
OMB Fast Track Memo_Infostatica_Request for Approval_Query Survey FINAL_For Clearance.docx OMB Fast Track Memo_Infostatica_Request for Approval_Query Survey FINAL_For Clearance	IC Document

IC Title:

Agency IC Tracking Number:

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 and Instruction	1				Yes	Yes	Fillable Fileable
Form and Instruction	2				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 900

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	Previously Approved
Annual Number of Responses for this IC	900	900
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Fast Track Memo_Infostatica_Request for Approval_Query Survey FINAL_For Clearance		01/09/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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