Questionnaire and Data Collection Testing, Evaluation, and Research for the Health Resources and Services Administration (HRSA)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Fast track memo - Research.docx	Supplementary Document	Uploaded 2026-09-22	Available
Supporting Statement B Revision 09222026.docx	Supporting Statement B	Uploaded 2026-09-22	Available
Supporting Statement A Revision 09222026.docx	Supporting Statement A	Uploaded 2026-09-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form

ICR Details

OMB Control No: 0915-0379	ICR Reference No: 202609-0915-001
Status: Received in OIRA	Previous ICR Reference No: 202306-0915-006
Agency/Subagency: HHS/HSA	Agency Tracking No: 21433
Title: Questionnaire and Data Collection Testing, Evaluation, and Research for the Health Resources and Services Administration (HRSA)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/23/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	11/30/2026
Responses	3,200	5,575
Time Burden (Hours)	3,120	3,482
Cost Burden (Dollars)	0	0

---

Abstract: The purpose of this Umbrella ICR is to inform the development of new questions, questionnaires, and tools; pilot/pre-test instruments under development; and identify problems in instruments currently in use by soliciting feedback from members of the public. Using this ICR, individual information collections related to the development or revision of HRSA data collection instruments go through an abbreviated approval process called a ‘‘generic’’ or ‘‘fast-track’’ information collection. This allows program offices to efficiently gather a suitable pool of candidates within the varied time periods available for participant recruitment. The specific statutes authorizing these collections cannot be identified in advance but will be included as part of each submission request to OMB. HRSA would only request OMB approval for collections under this umbrella-collection if the collection is voluntary, low-burden, and uncontroversial. As this Umbrella ICR focuses on the awareness, understanding, attitudes, preferences, or experiences of customers or other stakeholders (e.g., delivery partners, co-regulators, potential customers) relating to existing or future services, products or communication materials, the Fast Track Process should apply to this information collection. As part of this umbrella ICR, HRSA requests that OMB provide a response on individual generic collections within 5 business days. If no response is received and the request meets the purposes, uses and scope outlined in this document, HRSA would then move forward with the proposed information collection. No existing general information collections (ICs) will be renewed as part of the overall Umbrella Collection revision, and the individual IC template is included under Supporting Documents.

---

Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 36869	06/18/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 60136	09/22/2026
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 0

---

ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3,200	5,575	0	-2,375	0	0
Annual Time Burden (Hours)	3,120	3,482	0	-362	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There is a 43 percent decline in the estimated number of responses compared to the currently approved collection (from 5,575 to 3,200). Furthermore, there is a 10 percent decline in the estimated number of burden hours (from 3,482 to 3,120). This is due to a more streamlined burden table, which uses three general buckets of information collections (as opposed to seven in the currently approved version). This is based off the fact the collection types listed in the currently approved package have significant overlap in practice. For example, most focus groups, cognitive testing, and telephone interviews are now done over Zoom or similar video conferencing programs. Furthermore, there are no in-person collections in the currently approved Umbrella package.

---

Annual Cost to Federal Government: $2,680,259

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/23/2026

---