Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
In-Center Hemodialysis CAHPS Survey: Mode Modified 5000 1350 0 Form CMS-10105 Attachment C - Final ICH CAHPS Survey (English and Spanish)
Form CMS-10105 Attachment E - Telephone Script (English and Spanish)
In-Center Hemodialysis CAHPS Survey: National Implementation New 320000 86400 0 Form CMS-10105 Attachment C - Final ICH CAHPS Survey (English and Spanish)
Form CMS-10105 Attachment E - Telephone Script (English and Spanish)
Total burden requested under this ICR: 325000 87750 0  
To view an IC, click on IC Title