Primary Care Satisfaction Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Administrations)

Documents and Forms

Document Name Document Type
Patient Satisfaction Survey w Cover - VHA Pittsburgh 646 - Primary Care.pdf Other-Survey
Generic Clearance Request - VHA Pittsburgh 646 - Primary Care.docx Primary Care Satisfaction Survey IC Document

Information Collection (IC) Details

IC Title:	Primary Care Satisfaction Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			Patient Satisfaction Survey w Cover - VHA Pittsburgh 646 - Primary Care.pdf		No		Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,760	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	5,760	5,760
Annual IC Time Burden (Hours)	192	192
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Primary Care Satisfaction Survey	Generic Clearance Request - VHA Pittsburgh 646 - Primary Care.docx	08/25/2017

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