Data Submission

Medical Office Survey on Patient Safety Culture Comparative Database

OMB: 0935-0196

IC ID: 201169

Information Collection (IC) Details

View Information Collection (IC)

Data Submission
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form Form #4 Example Screen Shots of Web Site Information Collection Attachment E - Medical Office Survey Data File Specifications.pdf Yes Yes Fillable Fileable

Health Immunization Management

 

70 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 70 0 -80 0 0 150
Annual IC Time Burden (Hours) 70 0 -80 0 0 150
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment F: Databases TEP List Attachment F - SOPS Databases TEP List.doc 07/25/2018
Attachment D: Data Submission Emails Attachment D - Medical Office Data Submission Emails.docx 07/25/2018
Attachment G: Example Screen Shots of Medical Office Survey on Patient Safety Culture Data Submission Web Site Information Collection Attachment G - Example Screenshots of MO SOPS Data Submission Web Site Information Collection.docx 07/25/2018
Federal Register Notice 60 Day FRN.pdf 07/25/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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