Document
Form CMS-10534 Cognitive Interview Guide, Screener and Consent Forms
ICR 201904-0938-017 · OMB 0938-1185 · Object 91272601.
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1185 can be found here:
Document [html]
Download: html
%PDF-1.7 % 1647 0 obj <> endobj 1667 0 obj <>/Filter/FlateDecode/ID[<164AD89F2567754387D1FE654C9CAD9F><26975F8E9639DB4C910BF26E9814F9D7>]/Index[1647 45]/Info 1646 0 R/Length 92/Prev 344741/Root 1648 0 R/Size 1692/Type/XRef/W[1 2 1]>>stream hbbd``b`~ $7 5I4Vq $f$XtAZAyq$D h $X001qG 8X endstream endobj startxref 0 %%EOF 1691 0 obj <>stream hb``` cc`ah11YPa2`,< }wԦUx:XmlRl_my&YݰPs$.d8 $pgc f0h<>ؐ," 8eH,"!$lT9kgVyŇT$9ϯ:nO`h````` 60w4t4h4vt0Ht0if( J` 7BbEp13H0`Cu8'7D$5:0z20XmM{Ps {3$̐xJU%,4#0ځtX-|~ `q6UjQ` l= endstream endobj 1648 0 obj <>/Metadata 113 0 R/Names 1668 0 R/Outlines 207 0 R/PageLayout/OneColumn/Pages 1641 0 R/StructTreeRoot 243 0 R/Type/Catalog>> endobj 1649 0 obj <>/Font<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 1650 0 obj <>stream hYmo6+ؠwQ@ /jlɺ&kZ"/`˿݉(ESgo *x<LJac k&9SS2!6S` ͌&aP2Y.ictC"ȵ1XlsYz5[g,.zvKqwRpsٻwIנRlt||4YS\@uW'ICZMU}3mWo^vp?+9\+xtrQQxrnjq";MnLgE}tcIτ܃k9̫+i kլ5[M|2/OgzbMVdqQ.;_4٨̪d<'f.KW}\e5IE 41/kp:Zl*3:\~?:9g!"Nڔ#x\cP0M0@ن]cmܵPz ϜP T~ltus 07K4Qᅬqa(/ Jd)i4HIJK זå&L E:v8 v?6g;Wn-/y>*KU/*>_PKI-c(b2%ԖCl?Y W@scrB:%pY5;/gbxy ֮Oc{XWZɊ ko"iz(/CWn=aMnf OwC>=>eގ&hK#֚R K(pWɱB1uo;m}mS EmvkNc|`!4'oO ؆'reX`hq(`u"ӎ+gn%ĭŔf*ldΖ%nc: Y m[mT§Ŵ-.JexJf@p!}(,6.. &
%PDF-1.7 % 1647 0 obj <> endobj 1667 0 obj <>/Filter/FlateDecode/ID[<164AD89F2567754387D1FE654C9CAD9F><26975F8E9639DB4C910BF26E9814F9D7>]/Index[1647 45]/Info 1646 0 R/Length 92/Prev 344741/Root 1648 0 R/Size 1692/Type/XRef/W[1 2 1]>>stream hbbd``b`~ $7 5I4Vq $f$XtAZAyq$D h $X001qG 8X endstream endobj startxref 0 %%EOF 1691 0 obj <>stream hb``` cc`ah11YPa2`,< }wԦUx:XmlRl_my&YݰPs$.d8 $pgc f0h<>ؐ," 8eH,"!$lT9kgVyŇT$9ϯ:nO`h````` 60w4t4h4vt0Ht0if( J` 7BbEp13H0`Cu8'7D$5:0z20XmM{Ps {3$̐xJU%,4#0ځtX-|~ `q6UjQ` l= endstream endobj 1648 0 obj <>/Metadata 113 0 R/Names 1668 0 R/Outlines 207 0 R/PageLayout/OneColumn/Pages 1641 0 R/StructTreeRoot 243 0 R/Type/Catalog>> endobj 1649 0 obj <>/Font<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 1650 0 obj <>stream hYmo6+ؠwQ@ /jlɺ&kZ"/`˿݉(ESgo *x<LJac k&9SS2!6S` ͌&aP2Y.ictC"ȵ1XlsYz5[g,.zvKqwRpsٻwIנRlt||4YS\@uW'ICZMU}3mWo^vp?+9\+xtrQQxrnjq";MnLgE}tcIτ܃k9̫+i kլ5[M|2/OgzbMVdqQ.;_4٨̪d<'f.KW}\e5IE 41/kp:Zl*3:\~?:9g!"Nڔ#x\cP0M0@ن]cmܵPz ϜP T~ltus 07K4Qᅬqa(/ Jd)i4HIJK זå&L E:v8 v?6g;Wn-/y>*KU/*>_PKI-c(b2%ԖCl?Y W@scrB:%pY5;/gbxy ֮Oc{XWZɊ ko"iz(/CWn=aMnf OwC>=>eގ&hK#֚R K(pWɱB1uo;m}mS EmvkNc|`!4'oO ؆'reX`hq(`u"ӎ+gn%ĭŔf*ldΖ%nc: Y m[mT§Ŵ-.JexJf@p!}(,6.. &