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

Document Name
Form 8 ED Director Interview Guide Form and Instruction
Form 6 EDT Implementer Interview Guide Form and Instruction
Form 6 Patient Interview guide Form and Instruction
Form 5 EDT Implementers Focus Group Guide Form and Instruction
Form 4 Research assistant Focus Group Guide Form and Instruction
Form 3 Three-Month Patient Follow-up Questionnaire Form and Instruction
Form 2 One-Month Patient Follow-up Telephone Call Form and Instruction
Form 1 Emergency Department Discharge Tool (EDT) Form and Instruction
OMB SS Part B FINAL.doc Supporting Statement B
Attachment B - EDT User Guide 2013.12.13.docx Supplementary Document
OMB SS Part A – FINAL.doc Supporting 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All Historical Document Collections

201402-0935-002

Approved with change

New collection (Request for a new OMB Control Number)

2014-02-26