OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Pilot Test of the Proposed Pharmacy Survey on Patient Safety Culture

OMB 0935-0183 · HHS/AHRQ.

OMB 0935-0183

Latest Forms, Documents, and Supporting Material

Document Name
Form Form #3 Pharmacy background questionnaire Form and Instruction
Form Form #2 Pretest Form and Instruction
Form Form #1 Cognitive interviews Form and Instruction
Supporting Statement Part B -- Pilot Test of the Proposed Pharmacy SOPS 8-9-11.docx Supporting Statement B
Attachment F -- Federal Register Notice.pdf Supplementary Document
Attachment A -- Healthcare Research and Quality Act of 1999.pdf Supplementary Document
Attachment G -- List of expert reviewers and consultants.docx Supplementary Document
Attachment D -- Pretest Cover Letter and Reminder Notice 2-8-11.docx Supplementary Document
Supporting Statement Part A -- Pilot Test of the Proposed Pharmacy SOPS 8-9-11.docx Supporting Statement A
Pharmacy background questionnaire Form and Instruction
Pretest Form and Instruction
Cognitive interviews Form and Instruction

All Historical Document Collections

201106-0935-002

Approved with change

New collection (Request for a new OMB Control Number)

2011-06-07