Primary care site patient characteristics survey

The Re-engineered Visit for Primary Care (AHRQ REV)

OMB: 0935-0237

IC ID: 226742

Information Collection (IC) Details

View Information Collection (IC)

Primary care site patient characteristics survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2 Attachment H: Primary Care Site Patient Characteristics Survey Attachment H Primary Care Site Patient Characteristics Survey AHRQ. JSI_11.2016.fine.version.doc No   Fillable Fileable

Health Health Care Services

 

9 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  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 9 0 9 0 0 0
Annual IC Time Burden (Hours) 14 0 14 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 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.

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