Joes

Joint Outpatient Experience Survey (JOES)

Documents and Forms

Document Name Document Type
JOES-7 Questionnaire 10-3-2024.docx Other-Survey
JOES-C Questionnaire_Revised_10.3.2024.docx Other-Survey
JOES-Ambulatory Survey_10.4.2024.docx Other-Survey
JOES-Dental Survey_10.4.2024.docx Other-Survey
JOES-Emergency Department Survey_10.4.2024.docx Other-Survey
JOES-Walk-in Contraceptive Clinic Survey_10.4.2024.docx Other-Survey

Information Collection (IC) Details

IC Title:	JOES	Agency IC Tracking Number:	0720-JOES

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	JOES-7 Questionnaire 10-3-2024.docx	Yes	Yes	Fillable Fileable
Other-Survey	JOES-C Questionnaire_Revised_10.3.2024.docx	Yes	Yes	Fillable Fileable
Other-Survey	JOES-Ambulatory Survey_10.4.2024.docx	Yes	Yes	Fillable Fileable
Other-Survey	JOES-Dental Survey_10.4.2024.docx	Yes	Yes	Fillable Fileable
Other-Survey	JOES-Emergency Department Survey_10.4.2024.docx	Yes	Yes	Fillable Fileable
Other-Survey	JOES-Walk-in Contraceptive Clinic Survey_10.4.2024.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Joint Outpatient Experience	FR Citation: 89 FR 56347

Number of Respondents: 310,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 70 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	310,000	310,000
Annual IC Time Burden (Hours)	26,533	26,533
Annual IC Cost Burden (Dollars)	834,250	834,250

Documents for IC

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.