Patient Satisfaction Greeting Memo

Department of Memorandum

Veterans Affairs

Date: July 14, 2008

From VHA OMB Clearance Liaison (19E1)

Subj: Request for Approval of Generic Patient Satisfaction Survey (2900-0570)

To: VA OMB Clearance Officer (005E3)

Cananduaguia VA Medical Center requests permission to use a patient e-mail greeting program.

a. POINT OF CONTACT for this program is:

Colleen Weber

VISN 2 Webmanager

113 Holland Avenue

Albany, NY 12208

(518) 626-6202

http://vaww.visn2.med.va.gov/

http://www1.va.gov/visns/visn02/

b. PURPOSE: This program is used to allow individuals to send greetings to patients in the hospital through an email that will be delivered to the patient

c. BURDEN:

# of Users per year	Time to fill out in minutes	Total time in minutes	Minutes devided by 60	Total Burden Hours
25	5	125	2.08	2.08

Mary Stout