Form 1 Attachment A. PROMIS Item Bank V2.0

Questionnaire and Data Collection Testing, Evaluation, and Research for the Agency for Healthcare Research and Quality

Attachment A_Promis Items_112818

Advancing the Collection and Use of Patient –Reported Outcomes through Health Information Technology

OMB: 0935-0124

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0935-0124 can be found here:

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Form Approved
OMB No. 0935-0179
Exp. Date 11/30/2020

Attachment A. PROMIS Item Bank V2.0

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Public reporting burden for this collection of information is estimated to average 15 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-0179) AHRQ, 5600 Fishers Lane, # 07W41A, Rockville, MD 20857.

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Burn, Alexandra C
File Modified	0000-00-00
File Created	2021-01-20