Eligibility/Registration Forms

Nursing Home Survey on Patient Safety Culture Comparative Database

OMB: 0935-0195

IC ID: 201032

Information Collection (IC) Details

View Information Collection (IC)

Eligibility/Registration Forms
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form Form #1 Eligibility/Registration Forms Attachment B - NH Eligibility and Regis Forms.docx Yes Yes Fillable Fileable

Health Immunization Management

 

85 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 85 0 85 0 0 0
Annual IC Time Burden (Hours) 4 0 4 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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