National Practitioner Data Bank Usability Survey

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

Documents and Forms

Document Name Document Type
Form 1 National Practitioner Data Bank Usability Survey Form and Instruction
1 0915-0212_UsabiltyTesting Instrument_NPDBSystem 0915-0212_UsabiltyTesting Instrument_NPDBSystem.docx Form and Instruction
1 0915-0212_UsabiltyTesting Instrument_NPDBSystem 0915-0212_UsabiltyTesting Instrument_NPDBSystem.docx Form and Instruction
0915-0212_Fast track Memo (Updated).docx Original Generic Request IC Document
0915-0212_Fast track Memo (Updated).docx Original Generic Request IC Document

Information Collection (IC) Details

IC Title:	National Practitioner Data Bank Usability Survey	Agency IC Tracking Number:

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 and Instruction	1	0915-0212_UsabiltyTesting Instrument_NPDBSystem	0915-0212_UsabiltyTesting Instrument_NPDBSystem.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Original Generic Request	0915-0212_Fast track Memo (Updated).docx	01/09/2024

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