Information Collection

National Implementation

IC 216390 under ICR 201510-0938-003 · OMB 0938-1240.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1240 can be found here:

Documents and Forms

Document Name Document Type
OAS CAHPS_OMB_Attachment_B_Cover Letter_rev 10-2015 [rev 10-28-2015 by OSORA PRA].docx Other-Cover Letter
OAS CAHPS_OMB_Crosswalk_Cover_Letter_10-27-15 [rev 10-28-2015 by OSORA PRA].docx Other-Cover Letter Crosswalk

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Implementation	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
Other-Cover Letter			OAS CAHPS_OMB_Attachment_B_Cover Letter_rev 10-2015 [rev 10-28-2015 by OSORA PRA].docx		No		Paper Only
Other-Cover Letter Crosswalk			OAS CAHPS_OMB_Crosswalk_Cover_Letter_10-27-15 [rev 10-28-2015 by OSORA PRA].docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,808,900	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,808,900	2,808,900
Annual IC Time Burden (Hours)	365,157	365,157
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.