IOM Study, NCL Patient Satisfaction Survey, Battlecreek Urgent Care Survey, Tobacco & Nicotine Use Survey, VISN 1 Patient Satisfaction Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCA, VBA, VHA)

OMB: 2900-0770

IC ID: 213756

Information Collection (IC) Details

View Information Collection (IC)

IOM Study, NCL Patient Satisfaction Survey, Battlecreek Urgent Care Survey, Tobacco & Nicotine Use Survey, VISN 1 Patient Satisfaction Survey 2900-0770
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 10-10128 IOM VA Mental Health Services Evaluation 09-IOM VA MH Services Eval Non-VA Service Users Discussion Protocol 10-01-14-1.docx No   Fillable Printable
Form and Instruction 10-10130 IOM VA Mental Health Services Evaluation 10-IOM VA MH Services Eval Fam Friends Non-VA Service Users Discussion Protocol 10-01-14.docx No   Fillable Printable
Form and Instruction 10-10131 IOM VA Mental Health Services Evaluation 12-IOM VA MH Services Eval Non-VA Clinical Staff Discussion Protocol 10-03-14.docx No   Fillable Printable
Form and Instruction 10-10133 VISN 1 Patient Satisfaction Survey NCL Patient Satisfaction Questionnaire 6- 2011 final approved by OMB-1.docx No   Fillable Printable
Form and Instruction 10-10135 Battlecreek Urgent Care Survey Battlecreek Urgent Care Survey.docx No   Fillable Printable
Form and Instruction 10-10136 Tobacco and Smoking Cessation Survey smoking cessation.docx No   Fillable Printable

Health Health Care Services

 

2,990 0
   
Individuals or Households
 
   0 %

  Approved 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 2,990 0 2,990 0 0 0
Annual IC Time Burden (Hours) 897 0 897 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
IOM Generic Clearance Request IOM Discussion Groups_VA Generic Fast-Track Clearance Request_2014-11-04.docx 11/06/2014
Patient Satisfaction Questionaire Generic Clearance Generic_Clearance_Submission_Template_Endo-WHAV.docx 11/06/2014
Smoking and Nicotine Use Generic Clearance VA Generic Fast-Track Clearance Request Template_20131216.docx 11/06/2014
Battle Creek Urgent Care Generic Clearance VA Generic Fast-Track Clearance Request Urgent Care.docx 11/06/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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