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Patient Perception Surveys – Behavioral Health (CC)
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)
OMB: 0925-0648
IC ID: 255318
OMB.report
HHS/NIH
OMB 0925-0648
ICR 202307-0925-002
IC 255318
( )
Documents and Forms
Document Name
Document Type
Form 1
Patient Perception Surveys – Behavioral Health (CC)
Form
1 Adult Inpatient Behavioral Health survey
Adult Inpatient Behavioral Health Survey 8-3-22.docx
Form
2 Adult Outpatient Behavioral Health survey
Adult Outpatient Behavioral Health Survey 8-3-22.docx
Form
3 Pediatric Inpatient Behavioral health survey
Pediatric Inpatient Behavioral Health Survey 8-3-22.docx
Form
4 Pediatric Outpatient Behavioral Health survey
Pediatric Outpatient Behavioral Health Survey 8-3-22.docx
Form
Fast Track Request under GC 0925-0648 CC Patient Perception Surveys 8-15-22 Behavioral Health.docx
fast track template for Patient Behavioral Health survey
IC Document
Email Invitations to Participate in Patient Feedback Surveys.docx
email invitation
IC Document
Information Collection (IC) Details
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