View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Medicare Beneficiary and Family-Centered Satisfaction Survey
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10393 Yes Yes Fillable Fileable
Form and Instruction CMS-10393 Yes Yes Fillable Fileable
Instruction Yes Yes Fillable Fileable
Form and Instruction CMS-10393 Yes Yes Fillable Fileable
Instruction Yes Yes Fillable Fileable
Instruction Yes Yes Fillable Fileable
Instruction Yes Yes Fillable Fileable

Health Health Care Services

 

24,970 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 24,970 0 8,960 0 0 16,010
Annual IC Time Burden (Hours) 2,899 0 -1,104 0 0 4,003
Annual IC Cost Burden (Dollars) 31,213 0 11,200 0 0 20,013

Title Document Date Uploaded
Legislation 07/05/2017
Crosswalk 12/20/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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