OMB control number

Emergency Department Patient Experience of Care (EDPEC) Survey Mode Experiments (CMS-10543)

OMB 0938-1273 · HHS/CMS.

OMB 0938-1273

Latest forms, documents, and information collections
Document	Type
Form CMS-10543 EDPEC Discharged to Community	Form
Form CMS-10543 EDPEC Survey Telephone Script	Form and Instruction
Form CMS-10543 EDPEC Survey Telephone Script	Form and Instruction
Form CMS-10543 EDPEC for Admitted Patients: HCAHPS Add-on Version B	Form
Form CMS-10543 EDPEC Survey Telephone Script	Form and Instruction
Form CMS-10543 EDPEC for Admitted Patients: HCAHPS Add-on Version A	Form
Form CMS-10102 HCAHPS Only ARM, Mode Experiment	Form
201502-0938-005_EDPEC_Supporting_Statement_B (2015-2-24)_2015-04-06 Comm emfd 20150429 CLEAN.docx	Supporting Statement B
201502-0938-005_EDPEC_Supporting Statement A rev 02-26-2014 by OSORA PR emfd 20150429 CLEAN.docx	Supporting Statement A
EDPEC Discharged to Community	Form
EDPEC Discharged to Community	Form and Instruction
EDPEC Discharged to Community	Other-Letter (Mailed)
EDPEC for Admitted Patients: HCAHPS Add-on Version B	Form and Instruction
EDPEC for Admitted Patients: HCAHPS Add-on Version B	Form
EDPEC for Admitted Patients: HCAHPS Add-on Version B	Other-Cover Letter
EDPEC for Admitted Patients: HCAHPS Add-on Version A	Form and Instruction
EDPEC for Admitted Patients: HCAHPS Add-on Version A	Form
EDPEC for Admitted Patients: HCAHPS Add-on Version A	Other-Cover Letter
HCAHPS Only	Form
HCAHPS Only	Other-Letters: Initial and Follow Up

Historical document collections
Reference	Filing	Received	Concluded	Action
201502-0938-005	New collection (Request for a new OMB Control Number)	2015-02-27		Approved without change