CAPI Screenshots of Introductory Screen and Thank You Screen
Attachment 6. CAPI screenshots.docx
Medicare Current Beneficiary Survey (MCBS) (CMS-P-0015A)
CAPI Screenshots of Introductory Screen and Thank You Screen
OMB: 0938-0568
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-0568 can be found here:
Document [docx]
Download: docx | pdf
NORC | Attachment 6 CAPI Screenshots
Community Questionnaire Introduction Screen
OMB
No. 0938-0568, expires 2/29/2024
Community Questionnaire End Screen
OMB
No. 0938-0568, expires 2/29/2024
Community Questionnaire End Screen for Baseline Beneficiaries
OMB
No. 0938-0568, expires 2/29/2024
Facility Instrument Screenshot
Facility Screener Screenshot
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Attachment 7 CAPI Screenshots |
| Author | NORC |
| File Modified | 0000-00-00 |
| File Created | 2022-04-05 |
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