OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Collection of Information for: Agency for Healthcare Research and Quality’s (AHRQ) Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families – Evaluation

OMB 0935-0235 · HHS/AHRQ.

OMB 0935-0235

Latest Forms, Documents, and Supporting Material

Document Name
Form 6 Appendix F: Topic guide for Telephone Protocol- Guide Practice Champions Form and Instruction
Form 4 Appendix D: Post-Implementation Interview Protocol- Providers Form and Instruction
Form 3 Appendix C: Interview Guide- Baseline Practice Readiness Form and Instruction
Form 1 Attachment A: Baseline Practice Assessment Form and Instruction
Supporting Statement Part A final PASSBACK Clean.docx Supporting Statement A
Supporting Statement Part B 20160605.doc Supporting Statement B
Appendix F: Topic guide for Telephone Protocol- Guide Practice Champions Form and Instruction
Appendix E: Post-Implementation Focus Group Protocol- Practice Staff Instruction
Appendix D: Post-Implementation Interview Protocol- Providers Form and Instruction
Appendix C: Interview Guide- Baseline Practice Readiness Form and Instruction
Post-Implementation Focus Group for Patients and Family Members Instruction
Attachment A: Baseline Practice Assessment Form and Instruction

All Historical Document Collections

201610-0935-001

Approved with change

New collection (Request for a new OMB Control Number)

2016-11-08