OMB control number

Pilot Test of the Proposed Value and Efficiency Surveys and Communicating About Value Checklist

OMB 0935-0211 · HHS/AHRQ.

OMB 0935-0211

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form Form #10 Pretest for the CV checklist	Form and Instruction
Form Form #9 Cognitive interviews for the CV checklist	Form and Instruction
Form Form #8 Survey to identify items for CV checklist	Form and Instruction
Form Form #7 Medical office information form	Form and Instruction
Form Form #6 POC Administration of the Medical Office VE survey	Form and Instruction
Form Form #5 POC Administration of the Hospital VE survey	Form and Instruction
Form Form #4 Pretest for the Medical Office VE survey	Form and Instruction
Form Form #3 Pretest for the Hospital VE survey	Form and Instruction
Form Form #2 Cognitive interviews for the Medical Office VE survey	Form and Instruction
Form Form #1 Cognitive interviews for the Hospital VE survey	Form and Instruction
Supporting Statement Part B -- Pilot Test of the High Value and Efficiency Culture Surveys 1-10-2013.docx	Supporting Statement B
Attachment N -- Federal Register Notice.pdf	Supplementary Document
Attachment O - List of Expert Reviewers and Consultants.docx	Supplementary Document
Attachment L - Draft CV Checklist.docx	Supplementary Document
Attachment H - Pretest Cover Letter and Reminder Notice for Medical Office VE Survey.docx	Supplementary Document
Attachment G - Pretest Cover Letter and Reminder Notice for Hospital VE Survey.docx	Supplementary Document
Supporting Statement Part A -- Pilot Test of the Proposed Value and Efficiency Surveys and Checklist 1-10-2013.docx	Supporting Statement A
Pretest for the CV checklist	Form and Instruction
Cognitive interviews for the CV checklist	Form and Instruction
Survey to identify items for CV checklist	Form and Instruction
Medical office information form	Form and Instruction
POC Administration of the Medical Office VE survey	Form and Instruction
POC Administration of the Hospital VE survey	Form and Instruction
Pretest for the Medical Office VE survey	Form and Instruction
Pretest for the Hospital VE survey	Form and Instruction
Cognitive interviews for the Medical Office VE survey	Form and Instruction
Cognitive interviews for the Hospital VE survey	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
201304-0935-003	New collection (Request for a new OMB Control Number)	2013-04-25		Approved without change