Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Attachment A -- Clinical Staff Survey New 1500 375 0 Form and Instruction 1
Attachment B -- Staff Interview Guide – QI Lead New 30 30 0 Form and Instruction 2
Attachment C -- Staff Interview Guide – Additional Staff New 120 120 0 Form and Instruction 3
QI Measures New 60 600 0 Instruction
Quarterly Check-In Calls New 375 375 0 Other-agenda
Secondary data New 180 720 0 Other-Secondary data
Virtual Launch Meeting New 15 30 0 Other-slides
Other-Agenda
Total burden requested under this ICR: 2280 2250 0  
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