Department of Defense (DoD) Patient Safety Culture Survey

Department of Defense (DoD) Patient Safety Culture Survey

OMB: 0720-0034

IC ID: 5614

Documents and Forms
Document Name
Document Type
Other-Survey
Information Collection (IC) Details

View Information Collection (IC)

Department of Defense (DoD) Patient Safety Culture Survey
 
No Modified
 
Voluntary
 
32 CFR 199

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Collection Instrument 0720-0034, 7.16.2015.docx Yes Yes Fillable Fileable

Defense and National Security Operational Defense

 

14,022 0
   
Federal Government
 
   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 14,022 0 0 0 14,022 0
Annual IC Time Burden (Hours) 2,337 0 -47 0 2,384 0
Annual IC Cost Burden (Dollars) 64,641 0 64,641 0 0 0

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

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