380 VA VHA Inpatient Survey

American Customer Satisfaction Index "Customer Satisfaction Surveys"

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0007 can be found here:

Documents and Forms

Document Name Document Type
Form 380 380 VA VHA Inpatient Survey Form and Instruction
380 380 VA VAH Inpatient Survey 2010 380 VHAInpatient_Survey_10_Final.doc Form and Instruction

Information Collection (IC) Details

IC Title:	380 VA VHA Inpatient Survey	Agency IC Tracking Number:	380

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 and Instruction	380	380 VA VAH Inpatient Survey	2010 380 VHAInpatient_Survey_10_Final.doc		No		Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 350	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	350	350
Annual IC Time Burden (Hours)	70	70
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.