Veterans Millennium Act Emergency Care Benefit Satisfaction Survey

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Document Name Document Type
Veterans Millennium Act Emergency Care Benefit Satisfaction Survey Instrument 20170202.pdf www.va.gov/communitycare Other-Survey
SURVEY INVITATION - Millennium Act.docx Other-Survey Invitation
Survey Reminder Letter - Millennium Act.docx Other-Survey Reminder Letter
Veterans Millennium Act Emergency Care Benefit Satisfaction Survey ICR 20170202.docx Generic Request - Millennium Act IC Document

Information Collection (IC) Details

IC Title:	Veterans Millennium Act Emergency Care Benefit Satisfaction Survey	Agency IC Tracking Number:	2900-0770

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	Veterans Millennium Act Emergency Care Benefit Satisfaction Survey Instrument 20170202.pdf	https://www.va.gov/communitycare	Yes	Yes	Fillable Printable
Other-Survey Invitation	SURVEY INVITATION - Millennium Act.docx		No		Paper Only
Other-Survey Reminder Letter	Survey Reminder Letter - Millennium Act.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	233	233
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Request - Millennium Act	Veterans Millennium Act Emergency Care Benefit Satisfaction Survey ICR 20170202.docx	02/13/2017

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