2018 MOPS Hospitals

Generic Clearance for Questionnaire Pretesting Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Document Name Document Type
Form 1 2018 MOPS Hospitals Form and Instructi
1 Questionnaire MOPSHP_CONTENT_FOR_COGNITIVE TESTING_FINAL.xlsx Form and Instruction
2018 MOPS OMB Letter.docx OMB Memo IC Document
Attachment A MOPS Hospitals protocol clinical managers.docx Clinical Managers Protocol IC Document
Attachment B MOPS Hospitals Protocol CFO.docx Chief Financial Officers Protocol IC Document

Information Collection (IC) Details

IC Title:	2018 MOPS Hospitals	Agency IC Tracking Number:

IC Status: New

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	1	Questionnaire	MOPSHP_CONTENT_FOR_COGNITIVE TESTING_FINAL.xlsx		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	2018 MOPS OMB Letter.docx	04/23/2018
Clinical Managers Protocol	Attachment A MOPS Hospitals protocol clinical managers.docx	04/23/2018
Chief Financial Officers Protocol	Attachment B MOPS Hospitals Protocol CFO.docx	04/23/2018

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