VISN 1 Call Center Customer Service Survey / OKC HB Primary Care Satisfaction Survey

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⚠️ Notice: This information collection may be referencing outdated material.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
VISN 1 Call Center Script and Survey.docx Telephonic Survey Other-Script / Survey
VA Form 10-211014a Oklahoma City VAMC Home Based Primary Care (HBPC) Progra OKC PrimaryCareSurvey_10-211014A.pdf Form
VISN 1 Call Center Customer Service Survey Generic_Submission.docx VISN 1 Call Center Customer Service Survey Generic Submission IC Document
Generic Request_OKC HB Primary Care Satisfaction Survey.docx Generic Request OKC HB Primary Care Satisfaction Survey IC Document

Information Collection (IC) Details

IC Title:	VISN 1 Call Center Customer Service Survey / OKC HB Primary Care Satisfaction Survey	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
Other-Script / Survey			VISN 1 Call Center Script and Survey.docx	Telephonic Survey	No		Paper Only
Form	VA Form 10-211014a	Oklahoma City VAMC Home Based Primary Care (HBPC) Program	OKC PrimaryCareSurvey_10-211014A.pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,350	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	4,350	4,350
Annual IC Time Burden (Hours)	314	314
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
VISN 1 Call Center Customer Service Survey Generic Submission	VISN 1 Call Center Customer Service Survey Generic_Submission.docx	02/20/2014
Generic Request OKC HB Primary Care Satisfaction Survey	Generic Request_OKC HB Primary Care Satisfaction Survey.docx	02/20/2014

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