Adult HCBS Registration Form

Consumer Assessment of Healthcare Providers and Systems (CAHPS®)Home and Community Based Services (HCBS) Survey Database

OMB: 0935-0245

IC ID: 236877

Information Collection (IC) Details

View Information Collection (IC)

Adult HCBS Registration Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 Attachment A: Adult HCBS Registration Form Attachment A Registration Form.docx Yes Yes Fillable Fileable

Health Health Care Services

 

51 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 51 0 0 0 51 0
Annual IC Time Burden (Hours) 4 0 0 0 4 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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