Quarterly Update Protocol

Updating and Expanding the AHRQ Quality Indicators Toolkit for Hospitals

Documents and Forms

Document Name Document Type
Form Old - Form #2 Quarterly Update Protocol Form and Instruction
Old - Form #2 Old - Quarterly Update Protocol Attachment E -- Quarterly update protocol 05-19-10.doc Form and Instruction
Form - 2 Quarterly update protocol (includes informed consent sta Attachment C --Quarterly update protocol.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Quarterly Update 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 #2	Old - Quarterly Update Protocol	Attachment E -- Quarterly update protocol 05-19-10.doc		Yes	Yes	Paper Only
Form and Instruction	Form - 2	Quarterly update protocol (includes informed consent statement)	Attachment C --Quarterly update 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: 6	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	36	36
Annual IC Time Burden (Hours)	36	36
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.