Information Collection

Overton Brooks VAMC - ENT Department Survey

IC 240147 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⚠️ Notice: This information collection may be referencing outdated material.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
Overton Brooks VAMC_ENT Department Survey_revised per OMB passback_082020.docx	Other-Survey
Overton Brooks VAMC_ENT Department Survey_revised Aug 2020.docx Overton Brooks VAMC - ENT Department Survey	IC Document

IC Title:

Overton Brooks VAMC - ENT Department Survey

Agency IC Tracking Number:

2900-0770-VHA

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			Overton Brooks VAMC_ENT Department Survey_revised per OMB passback_082020.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

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	150	150
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Overton Brooks VAMC - ENT Department Survey	Overton Brooks VAMC_ENT Department Survey_revised Aug 2020.docx	08/14/2020

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