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Federal forms, ICRs, and supporting documents

Information Collection

CMS-10710.GenIC#5 - Medicare.gov Web Sat Survey (A11 Section 280)

IC 262620 under ICR 202402-0938-008 · OMB 0938-1382.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

CMS-10710.GenIC#5 - Medicare.gov Web Sat Survey (A11 Section 280)
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10710.GenIC#5 CMS-10710#5 - Medicare.gov Web Sat Survey (A11 Section 280) CMS-10710#5 - Medicare.gov Web Sat Survey (A11 Section 280) (30-day).pdf Yes Yes Fillable Fileable

Health Health Care Services

 

360,000 0
   
Individuals or Households
 
   0 %

  Requested 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 360,000 0 0 0 0 360,000
Annual IC Time Burden (Hours) 24,000 0 0 0 0 24,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10710#5 - Medicare.gov Web Sat Survey (A11 Section 280) (30-day) CMS-10710#5 - Medicare.gov Web Sat Survey (A11 Section 280) (30-day).docx 09/30/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.