OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Mail survey with reminder card, mail and phone follow-up

IC 190199 under ICR 200908-0935-001 · OMB 0935-0157.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Mail survey with reminder card, mail and phone follow-up
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form #1 CAHPS Health Literacy Survey Instrument Attachment B -- CAHPS Health Literacy Survey Instrument.doc Yes Yes Paper Only

Health Consumer Health and Safety

 

600 0
   
Individuals or Households
 
   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 600 0 600 0 0 0
Annual IC Time Burden (Hours) 250 0 250 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment C -- Pre-NotificationCoverLetters ReminderPCardLetterTelephone Script Attachment C -- Pre-NotificationCoverLetters ReminderPCardLetterTelephone Script.doc 07/28/2009
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.