OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

CAHPS Health Plan Health Literacy Module

IC 199359 under ICR 201109-0935-001 · OMB 0935-0189.

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

View Information Collection (IC)

CAHPS Health Plan Health Literacy Module
 
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 Plan Health Literacy Survey-- English Attachment B -- CAHPS Health Plan Health Literacy Survey -- English.docx Yes Yes Paper Only
Form and Instruction Form #2 CAHPS Health Plan Health Literacy Survey -Spanish Attachment C -- CAHPS Health Plan Health Literacy Survey -- Spanish.doc Yes Yes Paper Only

Health Immunization Management

 

1,000 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 1,000 0 1,000 0 0 0
Annual IC Time Burden (Hours) 417 0 417 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment D -- Pre-NotificationCoverLetters ReminderPCardLetterTelephone Script - English&Spanish Attachment D -- Pre-NotificationCoverLetters ReminderPCardLetterTelephone Script - English&Spanish.docx 09/20/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.