OMB control number

Health Care Systems for Tracking Colorectal Cancer Screening Tests

OMB 0935-0146 · HHS/AHRQ.

OMB 0935-0146

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form Form #13 Patient Focus Groups (post-intervention)	Form and Instruction
Form Form #12 Chart audits	Form and Instruction
Form Form #11 Control survey of clinicians and staff	Form and Instruction
Form Form #10 Post-intervention survey of clinicians and staff	Form and Instruction
Form Form #9 Pre-intervention survey of clinicians and staff	Form and Instruction
Form Form #8 Control informal interviews with selected providers and staff	Form and Instruction
Form Form #7 Post-intervention informal interviews with selected providers and staff	Form and Instruction
Form Form #6 Pre-intervention informal interviews with selected providers and staff	Form and Instruction
Form Form #5 Control practice focus groups	Form and Instruction
Form Form #4 Post-intervention practice focus groups	Form and Instruction
Form Form #3 Pre-intervention practice focus groups	Form and Instruction
Form Form #2 Screening Eligibility Assessment (SEA) Form	Form and Instruction
Form Form #1 Electronic patient record review	Form and Instruction
CRC omb passback.doc	Supplementary Document
Attachment C3_Brief Informal Interviews with Selected Providers and Staff at Each Practice.doc	Supplementary Document
Attachment C2_Focus group of providers and staff at each intervention and control practice.doc	Supplementary Document
Attachment C6_Patient Focus Groups.doc	Supplementary Document
Attachment C5_Patient Chart Audits.doc	Supplementary Document
Attachment C7_Electronic Records Review Eligibility Criteria.xls	Supplementary Document
Attachment C4_A survey of all clinicians and staff at each practice - FINALv2.doc	Supplementary Document
Attachment C1_A Screening Eligibility (SEA) Form - FINALv2.doc	Supplementary Document
Supporting Statement Part B - FINAL Resubmit - 10-28-2008.doc	Supporting Statement B
Attachment A -- Healthcare Research and Quality Act of 1999.pdf	Supplementary Document
Attachment B_60 Day FRN -- Healthcare Systems for Tracking Colorectal Cancer Screening Tests.pdf	Supplementary Document
Attachment D5_Patient Consent.doc	Supplementary Document
Attachment D4_ Practice consent.doc	Supplementary Document
Attachment D3_ Patient Reminder Letter.doc	Supplementary Document
Attachment D2_ Patient Invitation Letter.doc	Supplementary Document
Attachment D1_Screening Elibility Letter.doc	Supplementary Document
Supporting Statement Part A - FINAL Resubmit - 10-28-2008.doc	Supporting Statement A
Patient Focus Groups (post-intervention)	Form and Instruction
Chart audits	Form and Instruction
Control survey of clinicians and staff	Form and Instruction
Post-intervention survey of clinicians and staff	Form and Instruction
Pre-intervention survey of clinicians and staff	Form and Instruction
Control informal interviews with selected providers and staff	Form and Instruction
Post-intervention informal interviews with selected providers and staff	Form and Instruction
Pre-intervention informal interviews with selected providers and staff	Form and Instruction
Control practice focus groups	Form and Instruction
Post-intervention practice focus groups	Form and Instruction
Pre-intervention practice focus groups	Form and Instruction
Screening Eligibility Assessment (SEA) Form	Form and Instruction
Electronic patient record review	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
200807-0935-002	New collection (Request for a new OMB Control Number)	2008-07-30		Approved with change