Survey Materials

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Planned Survey Materials for 2022

View Current Survey Materials (for 2021)

The OAS CAHPS Survey materials available below will be take effect starting with January 2022. Implementation of web modes is dependent on approval in the calendar year 2022 Final Rule.

	English	Spanish	Simplified Chinese	Traditional Chinese	Korean
Protocols and Guidelines Manual
PDF Version (Manual w/ Appendices)	11/16/2021
MS Word Version (Manual w/ Appendices)	11/3/2021
Questionnaire
Mail Questionnaire	7/23/2021	10/6/2021	10/13/2021	10/13/2021	7/22/2021
Alternative instructions for scannable questionnaires	6/8/2016	11/5/2019			3/29/2017
CATI questionnaire	11/3/2021	11/3/2021	8/16/2021	8/16/2021
Web Questionnaire (PDF versions)	11/3/2021	11/3/2021	8/16/2021	8/16/2021
Web Questionnaire (MS Word versions)	11/3/2021	11/3/2021	8/16/2021	8/16/2021
Consent to Share Identifying Information Question	7/22/2021	7/22/2021	8/3/2021	8/3/2021	3/29/2017
OMB Disclosure Notice	10/20/2021	10/20/2021	10/20/2021	10/20/2021	10/20/2021
XML File Layouts
Standard Header Record	8/3/2021
DSRS Header Record	8/3/2021
Zero Sampled Patient File	8/3/2021
Example Patient File Layout	7/22/2021
FAQs for Interviewers	10/15/2021	9/15/2021	12/2/2021	12/2/2021
Sample Letters
Cover Letter for Mail-Only Mode, 1st mailing	11/3/2021	11/3/2021	8/3/2021	8/3/2021	11/3/2021
Cover Letter for Mail-Only Mode, 2nd mailing	11/3/2021	11/3/2021	8/3/2021	8/3/2021	11/3/2021
Initial Web Survey Invitation Letter	11/3/2021	11/3/2021
Initial Web Survey Invitation Email	11/3/2021	11/3/2021
Web Survey Reminder Letter (Day 14 contact)	11/3/2021	11/3/2021
Web Survey Reminder Email (Days 14 and 35 contacts)	11/3/2021	11/3/2021
Cover Letter for Questionnaire Mailing, Web with Mail Mode	11/3/2021	11/3/2021
(OPTIONAL) Prenotification for Telephone Only Mode	11/3/2021	11/3/2021	10/6/2021	10/6/2021