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Federal forms, ICRs, and supporting documents

Information Collection

VA Community Care Network Provider Satisfaction Survey for Regions 1, 2, 3 and 4

IC 232311 under ICR 201710-2900-001 · OMB 2900-0770.

Documents and Forms
Document Name
Document Type
Other-Survey
Other-Survey
Other-Survey
Other-Survey
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

VA Community Care Network Provider Satisfaction Survey for Regions 1, 2, 3 and 4 2900-0770
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey CCN Provider Survey Region 1 2018 June 27 v2.docx TBD Yes Yes Fillable Fileable
Other-Survey CCN Provider Survey Region 2 2018 June 27 v2.docx TBD Yes Yes Fillable Fileable
Other-Survey CCN Provider Survey Region 3 2018 June 27 v2.docx TBD Yes Yes Fillable Fileable
Other-Survey CCN Provider Survey Region 4 2018 June 27 v2.docx TBD Yes Yes Fillable Fileable

Health Health Care Services

 

8,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 8,000 0 8,000 0 0 0
Annual IC Time Burden (Hours) 1,333 0 1,333 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Request - CCN Provider Survey CCN Provider Survey ICR_080118.doc 08/01/2018
CCN Survey Invitation Survey Invitation.docx 08/01/2018
CCN Survey Reminder Letter Survey Reminder Letter.docx 08/01/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.