OMB control number

The Re-engineered Visit for Primary Care (AHRQ REV)

OMB 0935-0237 · HHS/AHRQ.

OMB 0935-0237

Latest Forms, Documents, and Supporting Material

Document Name
Form 7 Community Agency Interview Guide Form and Instruction
Form 6 Patient Interview Guide Form and Instruction
Form 5 Work Flow Mapping Follow-Up Interview Guide Form and Instruction
Form 4 Work Flow Mapping Group Interview Guide Form and Instruction
Form 3 Workflow mapping preliminary interview Form and Instruction
Form 2 Primary care site patient characteristics survey Form and Instruction
Form 1 Primary care site organizational characteristics survey; Attachment G Form and Instruction
Project REV OMB Package Supporting Statement A.04.20.17.fine.docx Supporting Statement A
Response 1.docx Supplementary Document
Attachment M Community Agency Interview Guide JSI_093016.AHRQ.fine.version.docx Supplementary Document
Attachment F Primary Care Site OverviewAHRQ.REV.JSI.11.2016.fine.version.doc Supplementary Document
Attachment E Fielding Data Collection and Analysis Methods AHRQ.REV.JSI.11.2016.fine.version.doc Supplementary Document
Attachment D Summary of Common Data Collection Instruments AHRQ.REV.JSI.11.2016.fine.version.doc Supplementary Document
Attachment C Pilot Methods AHRQ.REV.JSI.11.2016.fine.version.doc Supplementary Document
Attachment B Contract Staff Consultant and TEP Lists AHRQ.REV.JSI.11.2016.fine.version..doc Supplementary Document
Community Agency Interview Guide Form and Instruction
Patient Interview Guide Form and Instruction
Work Flow Mapping Follow-Up Interview Guide Form and Instruction
Work Flow Mapping Group Interview Guide Form and Instruction
Workflow mapping preliminary interview Form and Instruction
Primary care site patient characteristics survey Form and Instruction
Primary care site organizational characteristics survey; Attachment G Form and Instruction

All Historical Document Collections

201704-0935-002

Approved without change

New collection (Request for a new OMB Control Number)

2017-05-10