Data Collection

Evaluation of the Graduate Nurse Education Demonstration Program (CMS-10467)

OMB: 0938-1212

IC ID: 207736

Information Collection (IC) Details

View Information Collection (IC)

Data Collection
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10467 Attachment 2: Qualitative Data Collection Protocol Attach2QualData.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10467 Verbal Consent Statement 2nd Passback CMS-10467 Evaluation of GNE Demo Attachment 2 Verbal Consent.docx Yes Yes Fillable Fileable
Form and Instruction CMS-10467 Qualitative Data Collection Protocols 2nd Passback CMS-10467 Evaluation of GNE Demo Attachment 1 Qualitative Protocols_Clean_TO CMS.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

104 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 104 0 -486 0 0 590
Annual IC Time Burden (Hours) 802 0 102 0 0 700
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment 1: Crosswalk Attach1CrossSumm.pdf 01/21/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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