Replacing Durable Medical Equipment and Prescription Drugs after a Disaster Addressing the Needs of Medicare Beneficiaries Post-training Feedback Survey (CMS-10828)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (CMS-10415)

OMB: 0938-1185

IC ID: 257143

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Form and Instruction
Form and Instruction
Form and Instruction
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IC Document
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Replacing Durable Medical Equipment and Prescription Drugs after a Disaster Addressing the Needs of Medicare Beneficiaries Post-training Feedback Survey (CMS-10828)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10828 Post-Webinar Feedback Survey CMS-10828 Post-webinar Evaluation SurveyGoogle Forms_092822.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

60 0
   
State, Local, and Tribal Governments
 
   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 60 0 60 0 0 0
Annual IC Time Burden (Hours) 10 0 10 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10828 MEMO_ Fasttrack Generic Clearance Submission CMS-10828 MEMO_ Fasttrack Generic Clearance Submission.docx 11/28/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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