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    • CAHPS® Hospice Survey


    QAG V11.0 Survey Materials


    CAHPS Hospice Survey Instruments posted below have been approved by OMB. To view or download a PDF version of the survey, click on the links below.

    English Survey Materials

    Click here to view or download the Interviewing Guidelines Telephone
    Click here to view or download the FAQ
    Click here to view or download the Examples of Supplemental Questions
    Click here to view or download the Informational Flyer 
    Click here to view or download the Prenotification Letter 
    Click here to view or download the Mail Survey Materials (February 2025)
    Click here to view or download the Telephone Script (February 2025)
    Click here to view or download the Web Survey Materials (February 2025)

    Spanish Survey Materials

    Click here to view or download the Interviewing Guidelines Telephone
    Click here to view or download the FAQ
    Click here to view or download the Examples of Supplemental Questions
    Click here to view or download the Informational Flyer 
    Click here to view or download the Prenotification Letter 
    Click here to view or download the Mail Survey Materials (February 2025)
    Click here to view or download the Telephone Script (February 2025)
    Click here to view or download the Web Survey Materials (February 2025)

    SImplified Chinese Materials

    Click here to view or download the Mail Survey
    Click here to view or download the Web Survey
    Click here to view or download the OMB Statement
    Click here to view or download the Prenotification Letter
    Click here to view or download the Initial Cover Letter 
    Click here to view or download the Follow-up Cover Letter 
    Click here to view or download the Email Invitation
    Click here to view or download the Email Reminder
    Click here to view or download the Additional Formatting – Appendix P

    Traditional Chinese Materials

    Click here to view or download the Mail Survey
    Click here to view or download the Web Survey
    Click here to view or download the OMB Statement
    Click here to view or download the Prenotification Letter
    Click here to view or download the Initial Cover Letter 
    Click here to view or download the Follow-up Cover Letter 
    Click here to view or download the Email Invitation
    Click here to view or download the Email Reminder
    Click here to view or download the Additional Formatting – Appendix P

    Korean Materials

    Click here to view or download the Mail Survey
    Click here to view or download the Web Survey
    Click here to view or download the OMB Statement
    Click here to view or download the Prenotification Letter
    Click here to view or download the Initial Cover Letter 
    Click here to view or download the Follow-up Cover Letter 
    Click here to view or download the Email Invitation
    Click here to view or download the Email Reminder
    Click here to view or download the Additional Formatting – Appendix P

    Polish Materials

    Click here to view or download the Mail Survey
    Click here to view or download the Web Survey
    Click here to view or download the OMB Statement
    Click here to view or download the Prenotification Letter
    Click here to view or download the Initial Cover Letter 
    Click here to view or download the Follow-up Cover Letter 
    Click here to view or download the Email Invitation
    Click here to view or download the Email Reminder
    Click here to view or download the Additional Formatting – Appendix P

    Portuguese Materials

    Click here to view or download the Mail Survey
    Click here to view or download the Web Survey
    Click here to view or download the OMB Statement
    Click here to view or download the Prenotification Letter
    Click here to view or download the Initial Cover Letter 
    Click here to view or download the Follow-up Cover Letter 
    Click here to view or download the Email Invitation
    Click here to view or download the Email Reminder
    Click here to view or download the Additional Formatting – Appendix P

    Russian Materials

    Click here to view or download the Mail Survey
    Click here to view or download the Web Survey
    Click here to view or download the OMB Statement
    Click here to view or download the Prenotification Letter
    Click here to view or download the Initial Cover Letter 
    Click here to view or download the Follow-up Cover Letter 
    Click here to view or download the Email Invitation
    Click here to view or download the Email Reminder
    Click here to view or download the Additional Formatting – Appendix P

    VIetnamese Materials

    Click here to view or download the Mail Survey
    Click here to view or download the Web Survey
    Click here to view or download the OMB Statement
    Click here to view or download the Prenotification Letter
    Click here to view or download the Initial Cover Letter 
    Click here to view or download the Follow-up Cover Letter 
    Click here to view or download the Email Invitation
    Click here to view or download the Email Reminder
    Click here to view or download the Additional Formatting – Appendix P

    QAG V10.0 Survey Materials

    CAHPS Hospice Survey mail materials are available in English, Spanish, Traditional Chinese, Simplified Chinese, Russian, Portuguese, Vietnamese, Polish, and Korean. There are three response options for each mail survey (square, oval, and circle). The cover letters for the initial and follow-up mailing along with the OMB Paperwork Reduction Act Language are provided in each translation.

    CAHPS Hospice Survey Telephone Scripts are available in English, Spanish, and Russian.

    [ View V10.0 Survey Materials ]

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      CAHPS® Hospice Survey