Information Collection

Veterans Millennium Act Emergency Care Benefit Satisfaction Survey

IC 225627 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⚠️ Notice: This information collection may be referencing outdated material.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
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.