Information Collection

Telephone Survey on User Experience and Satisfaction with the Virtual Lifetime Electronic Record (VLER) Health Data Exchange

IC 199627 under ICR 201403-2900-007 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Provider-Interview-Guide_110701_v9_LM[1].docx Telephone survey	Other-Interviewer Script
Veteran_(Patient)_Interview-Guide-v22-110701_LM[1].docx Telephone surveys	Other-Interviewer Script
VLER__Generic_Clearance_Request_Form_LM_111103[1].docx Interviews on User Experience and Satisfaction with the Virtual Lifetime Electronic Record (VLER) Health Data Exchange	IC Document
VLER_Methods for provider and patient interviews_110816.docx Methods for ¿User Experience and Satisfaction with the Virtual Lifetime Electronic Record (VLER) Health Data Exchange	IC Document

IC Title:

Telephone Survey on User Experience and Satisfaction with the Virtual Lifetime Electronic Record (VLER) Health Data Exchange

Agency IC Tracking Number:

2900-0770

IC Status: Unchanged

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-Interviewer Script			Provider-Interview-Guide_110701_v9_LM[1].docx	Telephone survey	No		Paper Only
Other-Interviewer Script			Veteran_(Patient)_Interview-Guide-v22-110701_LM[1].docx	Telephone surveys	No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 220

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	220	220
Annual IC Time Burden (Hours)	55	55
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Interviews on User Experience and Satisfaction with the Virtual Lifetime Electronic Record (VLER) Health Data Exchange	VLER__Generic_Clearance_Request_Form_LM_111103[1].docx	11/09/2011
Methods for Â¿User Experience and Satisfaction with the Virtual Lifetime Electronic Record (VLER) Health Data Exchange	VLER_Methods for provider and patient interviews_110816.docx	10/02/2011

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