1. VISN 1 Outpatient Mental Health Patient Satisfaction Survey / 2. VE NCA Survey_Non-Sub Change

VISN 1 Outpatient Mental Health Patient
Satisfaction Survey
OMB No. 2900-0770
Estimated Burden: 10 minutes
Expiration Date: 9/30/2020

The Paperwork Reduction Act of 1995: This information is collected in accordance with section 3507 of
the Paperwork Reduction Act of 1995. Accordingly, we may not conduct or sponsor and you are not required
to respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time
expended by all individuals who complete this survey will average 10 minutes. This includes the time it will
take to follow instructions, gather the necessary facts and respond to questions asked. Customer
satisfaction is used to gauge customer perceptions of VA services as well as customer expectations and
desires. The results of this telephone/mail survey will lead to improvements in the quality of service delivery
by helping to achieve services. Participation in this survey is voluntary and failure to respond will have no
impact on benefits to which you may be entitled.

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