Revised VE Outpatient 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⚠️ Notice: This information collection may be referencing outdated material.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
2900-0770 VE OutpatSrveyRatingScaleMeasure08032017.pdf Other-E-Survey
WhitePaper_Non-Sub Change-VE Outpatient Survey Questions.docx WhitePaper_Non-Sub Change-VE Outpatient Survey IC Document
2900-0770 Justification_VE OutPat Appointment Scheduling SurveyJUN2017.docx 2900-0770 Justification_VE OutPat Appointment Scheduling Survey IC Document

Information Collection (IC) Details

IC Title:	Revised VE Outpatient 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-E-Survey			2900-0770 VE OutpatSrveyRatingScaleMeasure08032017.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	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	200	200
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
WhitePaper_Non-Sub Change-VE Outpatient Survey	WhitePaper_Non-Sub Change-VE Outpatient Survey Questions.docx	10/24/2017
2900-0770 Justification_VE OutPat Appointment Scheduling Survey	2900-0770 Justification_VE OutPat Appointment Scheduling SurveyJUN2017.docx	10/24/2017

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