Information Collection

Technical Assistance (TA) User Feedback for Program and User Support and Quality Measure Tool Development for Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Surveys on Patient Sa

IC 231329 under ICR 201709-0935-001 · OMB 0935-0179.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0179 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Technical Assistance (TA) User Feedback for Program and User Support and Quality Measure Tool Development for Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Surveys on Patient Sa	Form and Instruction
1 Questions for Users of SOPS Technical Assistance SOPS TA User Feedback 4-17-2018.docx	Form and Instruction
2 Questions for Users of CAHPS Technical Assistance CAHPS TA User Feedback 4-17-2018.docx	Form and Instruction
SOPS TA User Feedback 4-27-2018EB3.docx Supporting Statement	IC Document
OMB Cover Letter.doc Cover Letter	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Technical Assistance (TA) User Feedback for Program and User Support and Quality Measure Tool Development for Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Surveys on Patient Sa

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Questions for Users of SOPS Technical Assistance	SOPS TA User Feedback 4-17-2018.docx		Yes	Yes	Fillable Fileable
Form and Instruction	2	Questions for Users of CAHPS Technical Assistance	CAHPS TA User Feedback 4-17-2018.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	SOPS TA User Feedback 4-27-2018EB3.docx	05/04/2018
Cover Letter	OMB Cover Letter.doc	05/04/2018

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