PCFDI Faculty Skill and Program Feasibility Survey

Primary Care Faculty Development Initiative

Documents and Forms

Document Name Document Type
Form 2 PCFDI Faculty Skill and Program Feasibility Survey Form
2 PCFDI Irvine's Leadership Behavior Survey PCFDI Leadership Behavior Survey final.docx Form
1 PCFDI Faculty Skill and Program Feasibility Survey PCFDI Faculty Skill Feasibility Survey Final.docx Form

Information Collection (IC) Details

IC Title:	PCFDI Faculty Skill and Program Feasibility Survey	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	2	PCFDI Irvine's Leadership Behavior Survey	PCFDI Leadership Behavior Survey final.docx		Yes	Yes	Fillable Fileable
Form	1	PCFDI Faculty Skill and Program Feasibility Survey	PCFDI Faculty Skill Feasibility Survey Final.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 36	Number of Respondents for Small Entity: 36

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	36	36
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	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.