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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Attachment A: Child HCAHPS Registration Form
Unchanged
300
25
0
Form and Instruction
1
Attachment A: Child HCAHPS Registration Form
Attachment B: Child HCAHPS Database Data Use Agreement
Unchanged
300
15
0
Form and Instruction
2
Attachment B: Child HCAHPS Database Data Use Agreement
Attachment D: Hospital Information Submission Form
Unchanged
300
25
0
Form and Instruction
3
Attachment D: Hospital Information Submission Form
Attachment E: Submission Emails
Unchanged
300
300
0
Form and Instruction
4
Attachment E: Submission Emails
Total burden requested under this ICR:
1200
365
0
To view an IC, click on IC Title