PaRIS Survey

Patient-Reported Indicator Survey (PaRIS) (CMS-10792)

OMB: 0938-1434

IC ID: 251724

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

PaRIS Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10792 OECD PaRIS Patient Questionnaire Attach2_PaRIS_Specifications.pdf Yes Yes Fillable Printable

Health Health Care Services

Medicare Current Beneficiary Survey (MCBS)  86 FR 8591

5,144 0
   
Individuals or Households
 
   100 %

  Requested 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 5,144 0 5,144 0 0 0
Annual IC Time Burden (Hours) 3,447 0 3,447 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
PaRIS Showcards Attach2_PaRIS_Showcards.pdf 02/22/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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