Professional Qualifications Medical/Peer Reviewers

Professional Qualifications, Medical and Peer Reviewers

Documents and Forms

Document Name Document Type
Form DHA 780 Professional Qualifications Medical/Peer Reviewers Form and Instruction
DHA 780 PROFESSIONAL QUALIFICATIONS MEDICAL/PEER REVIEWERS DHA780_ProfQualMedPeerReview_DRAFT_20250624_v2_RE.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Professional Qualifications Medical/Peer Reviewers	Agency IC Tracking Number:	0720-0005

Is this a Common Form? No		IC Status: Modified

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	DHA 780	PROFESSIONAL QUALIFICATIONS MEDICAL/PEER REVIEWERS	DHA780_ProfQualMedPeerReview_DRAFT_20250624_v2_RE.pdf		Yes	Yes	Fillable Printable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 99 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	2,000	2,000

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.