OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Pilot Test of an Emergency Department (ED) Discharge Tool

OMB 0935-0217 · HHS/AHRQ.

OMB 0935-0217

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 8 ED Director Interview GuideForm and Instruction
Form 6 EDT Implementer Interview GuideForm and Instruction
Form 6 Patient Interview guideForm and Instruction
Form 5 EDT Implementers Focus Group GuideForm and Instruction
Form 4 Research assistant Focus Group GuideForm and Instruction
Form 3 Three-Month Patient Follow-up QuestionnaireForm and Instruction
Form 2 One-Month Patient Follow-up Telephone CallForm and Instruction
Form 1 Emergency Department Discharge Tool (EDT)Form and Instruction
OMB SS Part B FINAL.docSupporting Statement B
Attachment B - EDT User Guide 2013.12.13.docx Supplementary Document
OMB SS Part A – FINAL.docSupporting Statement A
ED Director Interview Guide Form and Instruction
EDT Implementer Interview Guide Form and Instruction
Patient Interview guide Form and Instruction
EDT Implementers Focus Group Guide Form and Instruction
Research assistant Focus Group Guide Form and Instruction
Three-Month Patient Follow-up Questionnaire Form and Instruction
One-Month Patient Follow-up Telephone Call Form and Instruction
Emergency Department Discharge Tool (EDT) Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201402-0935-002 New collection (Request for a new OMB Control Number) 2014-02-26 Approved with change