Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0274 can be found here:

Documents and Forms

Document Name Document Type
Form 3206-XXXX Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey Form and Instruction
3206-XXXX CAHPS Survey CAHPS Survey.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3206-XXXX	CAHPS Survey	CAHPS Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title: OPM SORN CENTRAL-18-Federal Employees Health Benefits Program Claims Data Warehouse	FR Citation: 84 FR 12569

Number of Respondents: 73,505	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	73,505	73,505
Annual IC Time Burden (Hours)	18,376	18,376
Annual IC Cost Burden (Dollars)	197,546	197,546

Documents for IC

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.