Form 1 Readiness for Change Assessment

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Attachment B_Readiness for Change Assessment_101818

Readiness for Change Assessment

OMB: 0935-0179

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0935-0179 can be found here:

2023-10-05 - Extension without change of a currently approved collection

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Form Approved
OMB No. 0935-0179
Exp. Date 11/30/2020

Attachment B. Readiness for Change Assessment

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Public reporting burden for this collection of information is estimated to average 30 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-0179) AHRQ, 5600 Fishers Lane, # 07W41A, Rockville, MD 20857.

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Burn, Alexandra C
File Modified	0000-00-00
File Created	2021-01-13