State OMBudsman Interview Protocol and Survey

Process Evaluation and Special Studies Related to the Long-Term Care Ombudsman Program

OMB: 0985-0055

IC ID: 224903

Information Collection (IC) Details

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State Ombudsman Interview Protocol and Survey
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 State Ombudsman Interview State-Ombudsmen-Interview-Protocol.doc Yes Yes Fillable Fileable
Form 2 State Ombudsmen Survey State-Ombudsmen-Survey.doc Yes Yes Fillable Fileable

Community and Social Services Social Services

 

53 0
   
State, Local, and Tribal Governments
 
   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 53 0 0 0 0 53
Annual IC Time Burden (Hours) 98 0 0 0 0 98
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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