OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Patient Perpective of Delivery of Health Care Through the use of an Electronic Health Record Survey

OMB 0990-0361 · HHS/HHSDM.

OMB 0990-0361

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Physician Practice Fact Sheet _1_19_2011.docx Justification for No Material/Nonsubstantive Change
Physician Letter Template _1_19_2011.docx Justification for No Material/Nonsubstantive Change
Physician Practice Fact Sheet on ONC letterhead FINAL_10_15_10.docx Justification for No Material/Nonsubstantive Change
Physician Advance Letter template FINAL 10 15 10.docx Justification for No Material/Nonsubstantive Change
0990-PatientPerspective_App J1 Patient Focus Group Fact Sheet.doc Supplementary Document
0990-PatientPerspective_App J2 Focus Group Postcard.doc Supplementary Document
0990-PatientPerspective_App F1 Patient Letter English.doc Supplementary Document
0990-PatientPerspective_App G PracticeThank You letter.doc Supplementary Document
0990-PatientPerspective_App D1 Physician Practice Advance Letter.doc Supplementary Document
0990-PatientPerspecive_App D2 Physician Practice Fact Sheet.doc Supplementary Document
0990-PatientPerspective_App D3 Medical practice Followup Letter.doc Supplementary Document
0990-PatientPerspective_App I Patient recruitment log.doc Supplementary Document
Patients at Primary Care Pactices (Patient Focus Groups) Other-Script
Patients at Primary Care Practices Other-Script
Staff at Primary Care Practices Other-info

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201101-0990-001 No material or nonsubstantive change to a currently approved collection 2011-01-25 Approved without change
201005-0990-002 New collection (Request for a new OMB Control Number) 2010-05-24 Approved with change