OMB
.report
Search
Customer Satisfaction with AHRQ's Quality Measurement Initiatives
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0935-0179
IC ID: 203456
OMB.report
HHS/AHRQ
OMB 0935-0179
ICR 201104-0935-006
IC 203456
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0179 can be found here:
2023-10-05 - Extension without change of a currently approved collection
2020-09-21 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Form #1
Customer Satisfaction with AHRQ's Quality Measurement Initiatives
Form and Instruction
Form #1 MONAHRQ Host User Group Questionnaire
Attachment A -- MONAHRQ Host User Group Questionnaire.doc
Form and Instruction
Form #2 HCUP Partners Software Redesign Questionnaire
Attachment B -- HCUP Partners Software Redesign Questionnaire.doc
Form and Instruction
OMB Submission Form -- Customer Satisfaction with AHRQs Quality Measurement Initiatives.doc
OMB Submission Form -- Customer Satisfaction with AHRQs Quality Measurement Initiatives
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Customer Satisfaction with AHRQ's Quality Measurement Initiatives
Agency IC Tracking Number:
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 #1
MONAHRQ Host User Group Questionnaire
Attachment A -- MONAHRQ Host User Group Questionnaire.doc
Yes
Yes
Fillable Fileable
Form and Instruction
Form #2
HCUP Partners Software Redesign Questionnaire
Attachment B -- HCUP Partners Software Redesign Questionnaire.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
100
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
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
100
0
0
0
0
0
Annual IC Time Burden (Hours)
25
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Submission Form -- Customer Satisfaction with AHRQs Quality Measurement Initiatives
OMB Submission Form -- Customer Satisfaction with AHRQs Quality Measurement Initiatives.doc
07/20/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.