OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Patient-Reported Indicator Survey (PaRIS) (CMS-10792)

OMB 0938-1434 ยท HHS/CMS.

OMB 0938-1434

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CMS-10792 OECD PaRIS Patient QuestionnaireForm and Instruction
Form CMS-10792 PaRIS Eligibility ScreenerForm and Instruction
CMS-10792_0938-NEW_SSB.docxSupporting Statement B
PaRIS_PublicComment_Response.docx Supplementary Document
CMS-10792_0938-NEW_SSA.docxSupporting Statement A
Attach4_PaRISCogTestReport.pdf Supplementary Document
Attach3_PaRIS_FAQs.pdf Supplementary Document
Attach3_PaRIS_ReminderPostcard.pdf Supplementary Document
Attach3_PaRIS_AdvLtr.pdf Supplementary Document
PaRIS Survey Form and Instruction
PaRIS Survey Form and Instruction
PaRIS Eligibility Screener Form and Instruction
PaRIS Eligibility Screener Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202202-0938-004 New collection (Request for a new OMB Control Number) 2022-03-02 Approved with change