Survey of Veterans Perceptions of an Enhanced VA Outpatient Prescription Label

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCA, VBA, VHA)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Document Name Document Type
Form VA Form 10-0549 Survey of Veterans Perceptions of an Enhanced VA Outpatient Prescription Label Form
VA Form 10-0549 Rx Label Feedback Rx Label Feedback_10-0549.pdf URL to Be Determined Form
VA Generic_Clearance_Submission_Template_Rx Label Project_04-25-12.docx Survey of Veterans Perceptions of an Enhanced VA Outpatient Prescription Label IC Document

Information Collection (IC) Details

IC Title:	Survey of Veterans Perceptions of an Enhanced VA Outpatient Prescription Label	Agency IC Tracking Number:

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	VA Form 10-0549	Rx Label Feedback	Rx Label Feedback_10-0549.pdf	URL to Be Determined	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,600	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	5,600	5,600
Annual IC Time Burden (Hours)	373	373
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Survey of Veterans Perceptions of an Enhanced VA Outpatient Prescription Label	VA Generic_Clearance_Submission_Template_Rx Label Project_04-25-12.docx	06/06/2012

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