Information Collection

Survey of Veteran Enrollees Quality and Efficiency of VA Health Care

IC 185562 under ICR 200807-2900-001 · OMB 2900-0725.

Documents and Forms

Document Name Document Type
Form VA Form 10-21088 Survey of Veteran Enrollees Quality and Efficiency of VA Health Care Form and Instruction
VA Form 10-21088 Survey of Veteran Enrollees - Quality and Efficiency of Survey 10-21088.pdf To Be Determined Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Survey of Veteran Enrollees Quality and Efficiency of VA Health Care	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	VA Form 10-21088	Survey of Veteran Enrollees - Quality and Efficiency of VA Health Care	Survey 10-21088.pdf	To Be Determined	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80,080	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80,080	80,080
Annual IC Time Burden (Hours)	18,133	18,133
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.