Information Collection

Remote Veterans Apnea Management Platform (REVAMP) Customer Satisfaction Survey

IC 239118 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⚠️ Notice: This information collection may be referencing outdated material.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
REVAMP Customer Satisfaction Survey_revised May 2020.docx	Other-Survey
REVAMP Letter to CPAP Users_revised 2020.docx REVAMP Letter to CPAP Users	IC Document
Generic Supp Statement_REVAMP Satisfaction Survey_revised 2020.docx Generic Supporting Statement - REVAMP Customer Satisfaction Survey - revised 2020	IC Document

IC Title:

Remote Veterans Apnea Management Platform (REVAMP) Customer Satisfaction Survey

Agency IC Tracking Number:

VHA-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-Survey			REVAMP Customer Satisfaction Survey_revised May 2020.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

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	1,000	1,000
Annual IC Time Burden (Hours)	167	167
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
REVAMP Letter to CPAP Users	REVAMP Letter to CPAP Users_revised 2020.docx	05/19/2020
Generic Supporting Statement - REVAMP Customer Satisfaction Survey - revised 2020	Generic Supp Statement_REVAMP Satisfaction Survey_revised 2020.docx	05/19/2020

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