Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
In-Center Hemodialysis CAHPS Survey: Mode Removed 0 0 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 Modified 218656 59037 0 Other-Pre-Notification Letter (English and Spanish)
Other-Sample Cover Letter (English and Spanish)
Form CMS-10105 Medicare In-Center Hemodialysis Survey (English and Spanish)
Total burden requested under this ICR: 218656 59037 0  
To view an IC, click on IC Title