Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Attachment B – Safety culture survey_Data collection instrument New 12000 3000 0 Form and Instruction 1
Attachment D – Patient Experience Survey_Data collection instrument New 1800 666 0 Form and Instruction 2
Attachment J – Data collection instrument: Site Visit Assessment New 40 320 0 Form and Instruction 5
Readiness and Implementation assessment New 720 720 0 Form and Instruction 3
Form and Instruction 4
Total burden requested under this ICR: 14560 4706 0  
To view an IC, click on IC Title