Department of Defense (DoD) Patient Safety Culture Survey

Department of Defense (DoD) Patient Safety Culture Survey

OMB: 0720-0034

IC ID: 5614

Documents and Forms
Document Name
Document Type
Other-Questionnaire
Instruction
Information Collection (IC) Details

View Information Collection (IC)

Department of Defense (DoD) Patient Safety Culture Survey
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Questionnaire PSafety Questionnaire _ 3.28.2018.docx Yes Yes Fillable Fileable
Instruction Patient Safety Intro Screenshot_March 2018.docx Yes Yes Fillable Fileable

Defense and National Security Operational Defense

 

9,200 0
   
Federal Government
 
   100 %

  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 9,200 0 -14,022 9,200 0 14,022
Annual IC Time Burden (Hours) 1,533 0 -2,337 1,533 0 2,337
Annual IC Cost Burden (Dollars) 64,599 0 -64,641 64,599 0 64,641

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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