Information Collection

Consumer Assessment of Healthcare Providers and Systems- Primary Care Adult (CAHPS)

IC 192657 under ICR 201004-0935-002 · OMB 0935-0166.

Documents and Forms

Document Name Document Type
Form Form #10 Consumer Assessment of Healthcare Providers and Systems- Primary Care Adult (CAHPS) Form and Instruction
Form #10 Consumer Assessment of Healthcare Providers and Systems- Attachment K - CAHPS Questionnaire.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Consumer Assessment of Healthcare Providers and Systems- Primary Care Adult (CAHPS)	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 and Instruction	Form #10	Consumer Assessment of Healthcare Providers and Systems- Primary Care Adult (CAHPS)	Attachment K - CAHPS Questionnaire.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	1,125	1,125
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.