Information Collection

CMS Computer-Based Training (CBT) Evaluation Form

IC 276875 under ICR 202506-0938-017 · OMB 0938-1331.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10598 CMS Computer-Based Training (CBT) Evaluation Form	Form and Instruction
Form CMS-10598 CMS Computer-Based Training (CBT) Evaluation Form CMS Computer-Based Training (CBT) Evaluation Form	Form and Instruction
CMS-10598 CMS Computer-Based Training (CBT) Evaluation Form CMS-10598 - Stakeholder CBT Evaluation.docx	Form and Instruction
CMS-10598 CMS Computer-Based Training (CBT) Evaluation Form CMS-10598 - Stakeholder CBT Evaluation.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10598				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 19

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	19	19
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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