Information Collection

PTSD Family Caregiver Feedback/ARCH Focus Group/VA Courtesy Standards/PTSD Coach (Phone) Apps Survey

IC 205012 under ICR 201107-2900-001 · OMB 2900-0770.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ARCH_Focus_Group_Telephone_Script_(2)[1].docx	Other-Telephone Script
ARCH_Focus_Group_Discussion_Guide1.pdf	Instruction
Phone_Apps_Focus_Group_Guide_and_Script_(v4)[1].docx	Other-Focus Group Guide and Script
ARCH FocusGroup Letter.docx	Other-Notification Letter
VA Form 10-0495 Understanding PTSD for Family Caregivers: Feedback Surve PTSD and Family Caregivers Survey 10-0495.docx slu.qualtrics.com/SE/?SID=SV 7P6Zja6FxuVnhwF	Form
VA Form 10-0497 VA Courtesy Standards - The Golden Rule Approach Veteran VA Courtesy Standards-Golden Rule Approach 10-0497.doc	Form
VA Form 10-0496 PTSD Coach App Survey PTSD Phone Apps Survey 10-0496_v3.pdf	Form
VA Form 10-0496a Phone Apps Focus Group Demographic Questionnaire Phone Apps_Focus Group Demographic Questionnaire (v5).docx	Form
Generic_Request_PTSD_Caregiver_Training (v2).docx Feedback on Caregiver PTSD Training	IC Document
Generic_Request_ARCH_FocusGroup[1].docx Project ARCH Focus Group	IC Document
Generic_Request_VA Courtesy Standards.docx VA Courtesy Standards-Golden Rule Approach	IC Document
PTSD_Phone_Apps_Focus_Group-Survey_Submission_(v3).docx PTSD Phone Apps Focus Grp and Survey	IC Document

IC Title:

PTSD Family Caregiver Feedback/ARCH Focus Group/VA Courtesy Standards/PTSD Coach (Phone) Apps Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 1320.8(d)

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
Other-Focus Group Guide and Script			Phone_Apps_Focus_Group_Guide_and_Script_(v4)[1].docx		No		Paper Only
Form	VA Form 10-0495	Understanding PTSD for Family Caregivers: Feedback Survey	PTSD and Family Caregivers Survey 10-0495.docx	https://slu.qualtrics.com/SE/?SID=SV 7P6Zja6FxuVnhwF	Yes	Yes	Fillable Fileable
Other-Telephone Script			ARCH_Focus_Group_Telephone_Script_(2)[1].docx		No		Paper Only
Instruction			ARCH_Focus_Group_Discussion_Guide1.pdf		No		Paper Only
Form	VA Form 10-0497	VA Courtesy Standards - The Golden Rule Approach Veteran Feedback Form	VA Courtesy Standards-Golden Rule Approach 10-0497.doc		No		Paper Only
Form	VA Form 10-0496	PTSD Coach App Survey	PTSD Phone Apps Survey 10-0496_v3.pdf		No		Paper Only
Other-Notification Letter			ARCH FocusGroup Letter.docx		No		Paper Only
Form	VA Form 10-0496a	Phone Apps Focus Group Demographic Questionnaire	Phone Apps_Focus Group Demographic Questionnaire (v5).docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,420

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	4,420	4,420
Annual IC Time Burden (Hours)	1,353	1,353
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Feedback on Caregiver PTSD Training	Generic_Request_PTSD_Caregiver_Training (v2).docx	12/06/2012
Project ARCH Focus Group	Generic_Request_ARCH_FocusGroup[1].docx	12/10/2012
VA Courtesy Standards-Golden Rule Approach	Generic_Request_VA Courtesy Standards.docx	12/04/2012
PTSD Phone Apps Focus Grp and Survey	PTSD_Phone_Apps_Focus_Group-Survey_Submission_(v3).docx	12/11/2012

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