Information Collection

Generic Veterans Health Administration Customer Satisfaction Surveys

IC 44127 under ICR 200812-2900-015 · OMB 2900-0570.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0570 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 10-0463 Generic Veterans Health Administration Customer Satisfaction Surveys	Form
VA Form 10-0463 Service Member/Veteran Satisfaction survey 2900-0570 SMV satisfaction client.doc	Form
VA Form 10-0463A Service Member/Veteran Primary Caregiver Satisfaction Su 2900-0570 caregiver satisfaction client.doc	Form

IC Title:

Generic Veterans Health Administration Customer Satisfaction Surveys

Agency IC Tracking Number:

2900-0570

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 10-0463	Service Member/Veteran Satisfaction survey	2900-0570 SMV satisfaction client.doc		No		Paper Only
Form	VA Form 10-0463A	Service Member/Veteran Primary Caregiver Satisfaction Survey	2900-0570 caregiver satisfaction client.doc		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 885,797

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	885,797	885,797
Annual IC Time Burden (Hours)	125,347	125,347
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.