OMB control number
Pretest of the Ambulatory Surgery/Procedure Survey on Patient Safety Culture
OMB 0935-0216 · HHS/AHRQ.
OMB 0935-0216
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form Form # 3 POC Administration of the survey | Form and Instruction |
| Form Form # 2 Pretest for the Ambulatory Surgery SOPS | Form and Instruction |
| Form Form # 1 Cognitive interviews | Form and Instruction |
| Supporting Statement Part B -- Pretest of the Ambulatory Surgery Center SOPS.docx | Supporting Statement B |
| Attachment F - List of Expert Reviewers and Consultants.docx | Supplementary Document |
 Attachment E - Federal Register Notice.pdf | Supplementary Document |
| Attachment D - Pretest Cover Letter and Reminder Notice for Survey.docx | Supplementary Document |
| Supporting Statement Part A -- Pretest of the Ambulatory Surgery Center SOPS.docx | Supporting Statement A |
 POC Administration of the survey |
Form and Instruction |
| Pretest for the Ambulatory Surgery SOPS |
Form and Instruction |
| Cognitive interviews |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201309-0935-001 | New collection (Request for a new OMB Control Number) | 2013-09-30 | Approved without change |