Pre/Post-Test Interview Protocol

Updating and Expanding the AHRQ Quality Indicators Toolkit for Hospitals

Documents and Forms

Document Name Document Type
Form Old - Form #1 Pre/Post-Test Interview Protocol Form and Instruction
Old - Form #1 Old - Pre/Post-Test Interview Protocol Attachment D -- Pre & post-test interview protocol 10-9-09.doc Form and Instruction
Form 1 Pre-post interview protocol Attachment B -- Pre-post interview protocol.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Pre/Post-Test Interview Protocol	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	Old - Form #1	Old - Pre/Post-Test Interview Protocol	Attachment D -- Pre & post-test interview protocol 10-9-09.doc		Yes	Yes	Paper Only
Form and Instruction	Form 1	Pre-post interview protocol	Attachment B -- Pre-post interview protocol.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 180	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 Agency Discretion
Annual Number of Responses for this IC	180	180
Annual IC Time Burden (Hours)	180	180
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.