Consumer Assessment of Healthcare Providers and Systems (CAHPS) Adults

Performance Measurement Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0253 can be found here:

Documents and Forms

Document Name Document Type
Form 0 Consumer Assessment of Healthcare Providers and Systems (CAHPS) Adults Form and Instruction
0 Consumer Assessment of Healthcare Providers and Systems CAHPS 4.0H Adult Commercial_Questionnaire.doc Form and Instruction
CAHPS survey SSB.doc supporting statement B IC Document

Information Collection (IC) Details

IC Title:	Consumer Assessment of Healthcare Providers and Systems (CAHPS) Adults	Agency IC Tracking Number:

IC Status: Unchanged

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	0	Consumer Assessment of Healthcare Providers and Systems (CAHPS) � Adults	CAHPS 4.0H Adult Commercial_Questionnaire.doc		No		Paper Only

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 210,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	210,000	210,000
Annual IC Time Burden (Hours)	70,000	70,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
supporting statement B	CAHPS survey SSB.doc	04/15/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.