OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Vet Apptmnt Apps Satisfaction Srvy/Hem-Oncology Telehealth Satisfaction Svy

IC 206171 under ICR 201107-2900-001 · OMB 2900-0770.

Documents and Forms
Document Name
Document Type
Other-Mobile application
Other-Web-based
Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Vet Apptmnt Apps Satisfaction Srvy/Hem-Oncology Telehealth Satisfaction Svy
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Mobile application Vet Appt Mobile App Survey Form_10-10057.docx Web App URL TBD Yes Yes Fillable Fileable
Other-Web-based Hem-Oncology Telehealth Satisfaction Survey_10-10054 .doc TBD - Telemedicine Equipment Yes Yes Fillable Fileable
Instruction Procedure Script for Hem-Oncology Satisfaction Survey.docx No   Paper Only

Health Health Care Services

 

430 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 430 0 430 0 0 0
Annual IC Time Burden (Hours) 36 0 36 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Veteran Appointment Mobile Application Satisfaction Survey request Generic_Request_ Appointment Mobile App Survey.docx 03/22/2013
Patient Satisfaction Svy-Telemedicine/Hem Oncology Services Hem-Oncology Telehealth Generic_Clearance_Submission.docx 03/22/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.