OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Pharmacy Survey on Patient Safety Culture Database

OMB 0935-0218 · HHS/AHRQ.

OMB 0935-0218

Latest Forms, Documents, and Supporting Material

Document Name
Form 2 Pharmacy SOPS Database Data Use Agreement Form and Instruction
Form 3 Pharmacy Background Characteristics Form Form and Instruction
Form 1 Pharmacy SOPS Registration Form Form and Instruction
Attachment G - Example Screenshots of Pharmacy SOPS Data Submission Web Site_updated 6-13-17_clean.docx Supplementary Document
Attachment F - SOPS Databases TEP List_updated 6-13-17_clean.doc Supplementary Document
Supporting Statement Part B -- Pharm DB Renewal _OMB 6-13-17_clean.doc Supporting Statement B
Supporting Statement Part A -- Pharm DB Renewal_OMB 6-13-17_clean.docx Supporting Statement A
Attachment E - Community Pharmacy Survey Data File Specifications_updated 6-13-17_clean.docx Supplementary Document
Data Submission Emails Instruction
Pharmacy SOPS Database Data Use Agreement Form and Instruction
Pharmacy Background Characteristics Form Form and Instruction
Pharmacy SOPS Registration Form Form and Instruction

All Historical Document Collections

201702-0935-001 Approved	Discontinue	2020-02-04
201403-0935-003 Approved with change	New collection (Request for a new OMB Control Number)	2014-04-02