Information Collection Request

Medicare Beneficiary and Family-Centered Satisfaction Survey

ICR 201203-0938-008 · OMB 0938-1177 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10393 Medicare Beneficiary and Family-Centered Satisfaction Survey Form New Available
Bene Satis Survey-PRA-Supporting Stmt Pt B.docx Supporting Statement B Uploaded 2012-03-12 Available
CMS Medicare Beneficiary Survey Revision Crosswalk 022912.docx Supplementary Document Uploaded 2012-03-12 Available
CMS 10393 Bene Satis Survey-PRA Supporting Stmt-Pt A.docx Supporting Statement A Uploaded 2012-03-12 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
201543 Medicare Beneficiary and Family-Centered Satisfaction Survey Form New

ICR Details

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  Inventory as of this Action Requested Previously Approved
36 Months From Approved
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table that charts list of burden
IC Title Form No. Form Name
Medicare Beneficiary and Family-Centered Satisfaction Survey CMS-10393, CMS-10393 Appeals Survey ,   Complaint Survey



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