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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
HHCAHPS Survey
Modified
1176699
235340
0
Form
CMS-10275
Home Health Care CAHPS Survey (English)
Form
CMS-10275
Home Health Care CAHPS Survey (Russian)
Form
CMS-10275
Home Health Care CAHPS Survey (Spanish)
Form
CMS-10275
Home Health Care CAHPS Survey (Telephone)
Form
CMS-10275
Home Health Care CAHPS Survey (Telephone/Proxy)
Form
CMS-10275
Consent to Share Question #35 (English)
Form
CMS-10275
Consent to Share Question #35 (Chinese)
Form
CMS-10275
Consent to Share Question #35 (Russian)
Form
CMS-10275
Consent to Share Question #35 (Traditional Chinese)
Form
CMS-10275
Consent to Share Question #35 (Vietnamese)
Instruction
Instruction
Participation Exemption Request (PER) Form
Modified
1000
330
0
Form
CMS-10275
Participation Exemption Request (PER) Form
Patient Files
Modified
119196
238392
0
Instruction
Total burden requested under this ICR:
1296895
474062
0
To view an IC, click on IC Title
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