Information Collection

VISN 20 Specialty Access Initiative-Video Follow-Up Visits for Obstructive Sleep Apnea Therapy

IC 232026 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⚠️ Notice: This information collection may be referencing outdated material.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
VISN 20 Video Connect Veteran Guide.docx	Other-Interview Guide
OMB Generic Clearance Submission_VISN 20 Specialty Access.doc Generic Clearance_VISN 20 Specialty Access	IC Document

IC Title:

VISN 20 Specialty Access Initiative-Video Follow-Up Visits for Obstructive Sleep Apnea Therapy

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-Interview Guide			VISN 20 Video Connect Veteran Guide.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

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	50	50
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generic Clearance_VISN 20 Specialty Access	OMB Generic Clearance Submission_VISN 20 Specialty Access.doc	07/03/2018

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