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National Sample Survey of Nurse Practitioners
National Sample Survey of Nurse Practitioners
OMB: 0915-0348
IC ID: 200434
OMB.report
HHS/HSA
OMB 0915-0348
ICR 201112-0915-002
IC 200434
( )
Documents and Forms
Document Name
Document Type
Form 1
National Sample Survey of Nurse Practitioners
Form
1 NSSNP Questionnaire
OMB NSSNP Questionnaire_FINAL_2.17.12.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Sample Survey of Nurse Practitioners
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
1
NSSNP Questionnaire
OMB NSSNP Questionnaire_FINAL_2.17.12.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
14,300
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
14,300
0
14,300
0
0
0
Annual IC Time Burden (Hours)
4,719
0
4,719
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.