Attachment J – Data collection instrument: Site Visit Assessment

AHRQ Safety Program for Improving Surgical Care and Recovery

OMB: 0935-0239

IC ID: 227747

Information Collection (IC) Details

View Information Collection (IC)

Attachment J – Data collection instrument: Site Visit Assessment
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 5 Site visits Attachment J_Site visit Assessment_Data collection instrument_20170727.docx No   Fillable Fileable

Health Health Care Services

 

40 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 40 0 40 0 0 0
Annual IC Time Burden (Hours) 320 0 320 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment I – Site visit assessment_Cover letter and reminder notice.docx Attachment I_Site visit assessment_Cover letter and reminder notice_20170727.docx 07/28/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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