Health Professional Portal

National Center for Complementary and Alternative Medicine (NCCAM) Communications Program Planning and Evaluation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0530 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Health Professional Portal Form and Instruction
1 survey Survey Questions for Health Care Provider Portal Content 031710.doc Form and Instruction
cover memo 31710.doc cover memo 31710 IC Document
generic_clearance_form 31710.doc generic_clearance_form 31710 IC Document

Information Collection (IC) Details

IC Title:	Health Professional Portal	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	survey	Survey Questions for Health Care Provider Portal Content 031710.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 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	300	0	0	0	0	0
Annual IC Time Burden (Hours)	15	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
cover memo 31710	cover memo 31710.doc	03/18/2010
generic_clearance_form 31710	generic_clearance_form 31710.doc	03/18/2010

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