Information Collection

Customer Satisfaction with AHRQ's Quality Measurement Initiatives

IC 203456 under ICR 201104-0935-006 · OMB 0935-0179.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0179 can be found here:

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

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.