Information Collection

Update to VEO Outpatient Survey

IC 235217 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⚠️ Notice: This information collection may be referencing outdated material.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
Copy of OutpatientSurvey_Mockup_V3_030619.pdf	Instruction
Outpatient_Change Request_3.6.19.docx Outpatient Change Request	IC Document

IC Title:

Update to VEO Outpatient Survey

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
Instruction			Copy of OutpatientSurvey_Mockup_V3_030619.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,900,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,900,000	1,900,000
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Outpatient Change Request	Outpatient_Change Request_3.6.19.docx	03/08/2019

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