OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

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

IC 210436 under ICR 201403-2900-007 · OMB 2900-0770.

Documents and Forms
Document Name
Document Type
Other-Script / Survey
Form
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

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

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

Health Health Care Services

 

4,350 0
   
Individuals or Households
 
   0 %

  Requested 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 4,350 0 0 0 0 4,350
Annual IC Time Burden (Hours) 314 0 0 0 0 314
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.