OMB.report

Federal forms, ICRs, and supporting documents

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 Name
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All Historical Document Collections

201309-0935-001

Approved without change

New collection (Request for a new OMB Control Number)

2013-09-30