Information Collection

VISN 20 Cancer Care Survey, VA Research Currents

IC 218501 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⚠️ Notice: This information collection may be referencing outdated material.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
Form VA Form 10-10164 VISN 20 Cancer Care Survey, VA Research Currents	Form and Instruction
VA Form 10-10164 VISN 20 Cancer Care Survey VISN20 Cancer Care Survey_Veteran Satisfaction 081815.docx	Form and Instruction
VA Form 10-10167 Customer Satisfaction Survey on VA Research Communicatio VA Research Currents Reader Survey Final (092815).docx	Form and Instruction
fast-track-PRA-submission-short-form CCNT Edited 092315 CLEAN.doc CCNT Edited Clean Version	IC Document
Generic_Clearance_Submission_VHA_ORD Edited 092315 CLEAN.doc Research Currents ORD Edited 092315	IC Document

IC Title:

VISN 20 Cancer Care Survey, VA Research Currents

Agency IC Tracking Number:

2900-0770

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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
Form and Instruction	VA Form 10-10164	VISN 20 Cancer Care Survey	VISN20 Cancer Care Survey_Veteran Satisfaction 081815.docx		No		Paper Only
Form and Instruction	VA Form 10-10167	Customer Satisfaction Survey on VA Research Communication, VA Research Currents	VA Research Currents Reader Survey Final (092815).docx	TBD	No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,204

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,204	3,204
Annual IC Time Burden (Hours)	260	260
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CCNT Edited Clean Version	fast-track-PRA-submission-short-form CCNT Edited 092315 CLEAN.doc	10/06/2015
Research Currents ORD Edited 092315	Generic_Clearance_Submission_VHA_ORD Edited 092315 CLEAN.doc	10/06/2015

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