Information Collection Request

Performance Measurement Surveys

ICR 200908-3206-001 · OMB 3206-0253 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 3206-0253 OPM Website Feedback Form New Repair queued
Form 0 OPM Leadership 360 Form and Instruction New Available
Form 0 Consumer Assessment of Healthcare Providers and Systems (CAHPS) – Child Survey Form and Instruction New Available
Form 0 Consumer Assessment of Healthcare Providers and Systems (CAHPS) – Adults Form and Instruction New Available
30 day published PMS.pdf Supplementary Document Uploaded 2010-10-21 Available
Performance Measurement Surveys SSB-2010.doc Supporting Statement B Uploaded 2010-10-19 Available
Generic Survey Performance Measurement SSA 2010_1.doc Supporting Statement A Uploaded 2010-10-19 Available
60 day published2010-14837[1].pdf Supplementary Document Uploaded 2010-06-25 Repair queued
Generic Performance Measurement submission master.xls Supplementary Document Uploaded 2010-05-05 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
203663 OPM Website Feedback Form New
192587 OPM Leadership 360 Form and Instruction New
192586 Consumer Assessment of Healthcare Providers and Systems (CAHPS) – Child Survey Form and Instruction New
192585 Consumer Assessment of Healthcare Providers and Systems (CAHPS) – Adults Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2014 36 Months From Approved
814,950 0 0
372,213 0 0
200,000 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 814,950 0 0 814,950 0 0
Annual Time Burden (Hours) 372,213 0 0 372,213 0 0
Annual Cost Burden (Dollars) 200,000 0 0 200,000 0 0


Reginfo record details
  No