Information Collection

Follow-Up Study of a National Cohort of Gulf War and Gulf Era Veterans

IC 192951 under ICR 201005-2900-006 · OMB 2900-0780.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 10-0488 Follow-Up Study of a National Cohort of Gulf War and Gulf Era Veterans	Form and Instruction
VA Form 10-0488 Follow-Up Study of a National Cohort of Gulf War and Gul Survey Instrument 10-0488 (3).doc To Be Determined	Form and Instruction
VA Form 10-0488a Consent to Release Medical Records VA Form 10-0488a Consent to Release Medical Records.pdf To Be Determined	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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 and Instruction	VA Form 10-0488	Follow-Up Study of a National Cohort of Gulf War and Gulf Era Veterans	Survey Instrument 10-0488 (3).doc	To Be Determined	Yes	Yes	Fillable Fileable
Form	VA Form 10-0488a	Consent to Release Medical Records	VA Form 10-0488a Consent to Release Medical Records.pdf	To Be Determined	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 19,462

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	19,462	19,462
Annual IC Time Burden (Hours)	9,498	9,498
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.