Information Collection

Veterans Experience Feedback Tool: E-Comment Card

IC 230219 under ICR 201710-2900-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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
E-Comment Card_(Rev).pdf survey.voice.medallia.com/?vavoice-vftsurvey#	Other-Web: E-Comment Card
VEFeedbackeComment_NonSubChange_02.15.18 (3).docx Non-Substantive Change Request White Paper	IC Document
NOA VE Feedback Tool.pdf NOA VE Feedback 2017	IC Document
VE Feedback Tool - Generic Clearance Request (OMB 2900-0770)_03.15.2017.docx Generic Clearance Request (OMB 2900-0770)_03.15.2017	IC Document

IC Title:

Veterans Experience Feedback Tool: E-Comment Card

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Web: E-Comment Card			E-Comment Card_(Rev).pdf	https://survey.voice.medallia.com/?vavoice-vftsurvey#	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 135

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	135	135
Annual IC Time Burden (Hours)	11	11
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Non-Substantive Change Request White Paper	VEFeedbackeComment_NonSubChange_02.15.18 (3).docx	02/22/2018
NOA VE Feedback 2017	NOA VE Feedback Tool.pdf	02/22/2018
Generic Clearance Request (OMB 2900-0770)_03.15.2017	VE Feedback Tool - Generic Clearance Request (OMB 2900-0770)_03.15.2017.docx	02/22/2018

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