OMB control number

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

OMB 0935-0179 · HHS/AHRQ.

OMB 0935-0179

This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

The latest form for Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery expires 2026-11-30 and is listed under ICR 202501-0935-001.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
AHRQ Quality Indicators (QI) Subtask C.2.9.4 – Draft Survey	Form and Instruction
Maternal Health Indicators (MHI) Module Specific Feedback	Form and Instruction
SOPS TA User Feedback	Form and Instruction
Questions for Users of CAHPS Technical Assistance	Form and Instruction
Nominator/Partner Survey	Form and Instruction
SS Part A - 0935-0179 - Generic Clearance of Qualitative Feedback - final Oct 2026v3.docx	Supporting Statement A
revised data collections 0935-0179 October, 2026v2.docx	Supplementary Document
60 day FRN notice and correction about due date.pdf	Supplementary Document
Generic 0935-Short-Form Template MS revised to include cost estimatev2-OMB.docx	Supplementary Document
Supporting Statement Part B -- Generic Clearance.docx	Supporting Statement B
Attachment A -- Healthcare Research and Quality Act of 1999.pdf	Supplementary Document
Agency for Healthcare Research and Quality (AHRQ) Quality Indicators (QI) Comprehensive Customer Survey	Form and Instruction
Agency for Healthcare Research and Quality (AHRQ) Quality Indicators (QI) Module-specific User Survey	Form and Instruction
Questions for Users of CAHPS/SOPS Technical Assistance	Form and Instruction
Questions for Users of CAHPS/SOPS Technical Assistance	Form and Instruction
Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Division	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202610-0935-001	Extension without change of a currently approved collection	2026-10-27
202501-0935-001	No material or nonsubstantive change to a currently approved collection	2025-01-24
202310-0935-001	Extension without change of a currently approved collection	2023-10-05	Approved with change
202009-0935-002	Extension without change of a currently approved collection	2020-09-21	Approved without change
201709-0935-001	Extension without change of a currently approved collection	2017-09-26	Approved without change
201409-0935-009	Revision of a currently approved collection	2014-09-24	Approved with change
201104-0935-006	New collection (Request for a new OMB Control Number)	2011-04-28	Approved without change

OMB Details

AHRQ.gov Taxonomy Tree Test

Federal Enterprise Architecture: Health - Health Care Services

Information collection instruments
Form	Name	Electronic access	Type
Form 1	AHRQ.gov Taxonomy Tree Test	Fillable Fileable	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.