Nat'l Center on Homelessness Among Veterans - Customer Feedback Survey

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

Customer Feedback Survey_Natl Center on Veteran Homelessness_Final_Oct 2019

Nat'l Center on Homelessness Among Veterans - Customer Feedback Survey

OMB: 2900-0770

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National Center on Homelessness Among Veterans

Customer Feedback Survey

OMB No. 2900-0770
Estimated Burden: 5 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 all questions in this survey will average 5 minutes. This includes the time it will take to follow instructions, gather the necessary facts, and respond to questions asked. The results of this online survey will assist the National Center on Homelessness Among Veterans collect information about strong practices being conducted by community partners to help Veterans exit homelessness. Through this data collection, we will be able to share strategies and tactics that are helping to prevent and end homelessness in communities across the United States. Participation in this survey is voluntary, and failure to respond will have no impact on benefits to which you may be entitled.

Questions for National Center on Homelessness Among Veterans’ Web Page

Web Page Where Questions Will Reside: https://www.va.gov/homeless/nchav/index.asp

(The following statement should appear before the survey questions:)

VA appreciates your participation in this online survey. The results of the survey will assist the National Center on Homelessness Among Veterans in collecting information about strong practices being conducted by community partners to help Veterans exit homelessness. Through this data collection, we will be able to share strategies and tactics that are helping to prevent and end homelessness in communities across the United States. Submission of feedback is entirely voluntary. Any information you enter here is anonymous and will be kept private to the extent provided by law.


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. The OMB control number for this survey is 2900-0770. We anticipate that the time expended by all individuals who complete all questions in this survey will average 5 minutes.


Questions or comments concerning the accuracy of the burden estimate and any suggestions for reducing this burden should be sent to Susan Vieira @[email protected].



  1. Is there a research question about Veteran homelessness that you’d like for us to investigate? (a feedback, text dialoged button to click on by user)


  1. Are there education or training needs you’d like to see offered for VA or community provider staff? (a feedback, text dialoged button to click on by user)


  1. Are there program designs or specific program models that you believe would be helpful to have in your community? (a feedback, text dialoged button to click on by user)



  1. Does your community offer unique program designs or alternative type program models that you believe may be of interest or of benefit to other communities working to address the causes and effects of homelessness? (a feedback, text dialoged button to click on by user)



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorTaylor, Michael A. (VACO)
File Modified0000-00-00
File Created2021-01-15

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