Information Collection

Virtual Nursing Visits to Evaluate Blood Pressure - Provider & Clinician Opinion

IC 230918 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⚠️ Notice: This information collection may be referencing outdated material.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
VA Video Connect Patient Questions 28Mar18.docx To be determined	Other-User Inquiry
VA Video Connect Clinician Questions.docx To be determined	Other-User Inquiry
Generic Clearance Submission_Virtual Nursing Visits_Carrico 28Mar18.doc Generic Request_Virtual Nursing Visits	IC Document

IC Title:

Virtual Nursing Visits to Evaluate Blood Pressure - Provider & Clinician Opinion

Agency IC Tracking Number:

2900-0770

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-User Inquiry			VA Video Connect Clinician Questions.docx	To be determined	Yes	Yes	Fillable Printable
Other-User Inquiry			VA Video Connect Patient Questions 28Mar18.docx	To be determined	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 70

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	70	70
Annual IC Time Burden (Hours)	18	18
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generic Request_Virtual Nursing Visits	Generic Clearance Submission_Virtual Nursing Visits_Carrico 28Mar18.doc	04/12/2018

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