Memo on form number change

Memo on form number change.doc

Survey of Healthcare Experiences Dental Patient Satisfaction Survey

Memo on form number change

OMB: 2900-0764

Document [doc]
Download: doc | pdf

Department of Memorandum

Veterans Affairs


Date: August 19, 2013


From: Cynthia Harvey-Pryor, VHA PRA Compliance Liaison (10B4)


Subj: Revision to VA Form 10-0503


To: Veterans Affairs OMB Desk Officer (Dooling / Bashadi)



Due to an internal VA Forms number change request, the Dental Healthcare Experiences Survey form 10-0503 number has been revised. The new form number will be 10-10070. There has been a discrepancy with agency assigned form numbers and VHA sequential form numbers. The previous form number 0503 suffix was duplicative as that which is used by Veterans Benefits Administration.


VHA will be utilizing a 5 digit suffix for all new forms and replacing specific numbers in the 500 series that has current OMB approval.





File Typeapplication/msword
File TitleDepartment of
Authorvhacobickoa
Last Modified ByHarvey-Pryor, Cynthia
File Modified2013-08-20
File Created2013-08-20

© 2024 OMB.report | Privacy Policy