OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Assessing the Impact of the Patient Safety Improvement Corps (PSIC) Training Program

OMB 0935-0145 · HHS/AHRQ.

OMB 0935-0145

Latest Forms, Documents, and Supporting Material

Document Name
Form Form #3 Qualitative Interview Form and Instruction
Form Form #2 Organizational Leader Questionnaire Form and Instruction
Form Form #1 Training participant questionnaire Form and Instruction
AHRQ PSIC passback.doc Supplementary Document
Attachment G -- Semi-structured interview guide_10-29-08.doc Supplementary Document
Attachment D -- PSIC leadership questionnaire 10-29-08.doc Supplementary Document
Attachment C -- PSIC participant questionnaire 10-29-08.doc Supplementary Document
Supporting Statement Part B_PSIC Evaluation_10-29-08(2).doc Supporting Statement B
Attachment B -- Logic Model_06.09.08_for RESUBMISSION.doc Supplementary Document
Attachment H -- AHRQ PSIC Informed Consent Form_07-14-08.doc Supplementary Document
30 Day FRN Amendment -- Assessing the Impact of the PSIC Training.pdf Supplementary Document
Attachment I -- 60 Day FRN -- Assessing the Impact of the Patient safety Improvement Corps (PSIC) Training Program_4-16-08.pdf Supplementary Document
Attachment A -- Healthcare Research and Quality Act of 1999.pdf Supplementary Document
Attachment F -- AHRQ PSIC Leadership -- All Letters 06-24-08.doc Supplementary Document
Attachment E -- AHRQ PSIC Participant -- All Letters 06-24-08.doc Supplementary Document
Supporting Statement Part A_PSIC Evaluation_ 11-4-08.doc Supporting Statement A
Qualitative Interview Form and Instruction
Organizational Leader Questionnaire Form and Instruction
Training participant questionnaire Form and Instruction

All Historical Document Collections

200807-0935-003

Approved with change

New collection (Request for a new OMB Control Number)

2008-07-30