OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Participant Experience Survey

IC 258921 under ICR 202407-0935-001 · OMB 0935-0265.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Participant Experience Survey
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 4 Participant Experience Survey - Improving Antibiotic Use Cohort_Brick-and-Mortar Practices Attachment D Participant Experience Survey - Antibiotic Use Cohort_Brick and Mortar (updated).docx Yes Yes Fillable Fileable
Form and Instruction 5 Participant Experience Survey - Improving Antibiotic Use Cohort_Telemedicine-Only Organizations Attachment E Participant Experience Survey - Antibiotic Use Cohort_Telemedicine Only (updated).docx Yes Yes Fillable Fileable

Health Health Care Services

 

188 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 188 0 63 0 0 125
Annual IC Time Burden (Hours) 63 0 21 0 0 42
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.