OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Patient Centered Medical Home (PCMH) Staff Satisfaction Survey

IC 214366 under ICR 201412-0720-001 · OMB 0720-0059.

Documents and Forms
Document Name
Document Type
Other-Survey
Other-Email Invite
Other-Memo Reminder
Other-DMDC Survey Review Memo
Information Collection (IC) Details

View Information Collection (IC)

Patient Centered Medical Home (PCMH) Staff Satisfaction Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey PCMH SSS with Contractors - Screenshots.pdf Yes Yes Fillable Fileable
Other-Email Invite DHA Patient Centered Medical Home Survey invite.doc Yes Yes Fillable Fileable
Other-Memo Reminder Service PCMH Leads Memo.doc Yes Yes Fillable Fileable
Other-DMDC Survey Review Memo DMDC-recommendation-letter-PCMH-Staff-Satisfaction-Survey-OMB-Dec-18-2013.pdf Yes Yes Fillable Fileable

Defense and National Security Operational Defense

 

3,105 0
   
Individuals or Households
 
   100 %

  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 3,105 0 3,105 0 0 0
Annual IC Time Burden (Hours) 518 0 518 0 0 0
Annual IC Cost Burden (Dollars) 15,525 0 15,525 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.