Be the Match® Patient Services Survey

OMB 0906-0004

Be The Match® is dedicated to helping patients, caregivers and family members get the support they need to learn about their disease and treatment options, prepare for transplant and thrive after transplant. The services provided are intended to help navigate the bone marrow or cord blood transplant (transplant) process. This information will be used to determine helpfulness of existing services for a diverse population, identify areas for improvement and develop future programs.

The latest form for Be the Match® Patient Services Survey expires 2023-10-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 1 Patient Services Survey Form and Instruction
01232023 Email Invite Spanish - OPA Patient Support Center Survey OMB 0906-0004.docx Supplementary Document
01232023 Email Invite English - OPA Patient Support Center Survey OMB 0906-0004.docx Supplementary Document
06012023 - Supporting Statement A - OPA PSC Survey - OMB 0906-0004.docx Supporting Statement A
Patient Services Survey Form and Instruction

All Historical Document Collections

202306-0906-001 Approved without change	Revision of a currently approved collection	2023-06-14
202008-0906-002 Approved without change	Revision of a currently approved collection	2020-08-27
201711-0906-002 Approved with change	Revision of a currently approved collection	2017-11-13
201410-0906-001 Approved without change	New collection (Request for a new OMB Control Number)	2014-10-28