2020 002 Q_VAMyHealtheVet_Web_Browse_2020_1_17

E-Government Website Customer Satisfaction Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Document Name Document Type
Form 002 2020 002 Q_VAMyHealtheVet_Web_Browse_2020_1_17 Form and Instruction
002 2020 002 Q_VAMyHealtheVet_Web_Browse_2020_1_17 2020 002 Q_VAMyHealtheVet_Web_Browse_2020_1_17.xlsx Form and Instruction
1090-0008 Generic Clearance Request Form MyHealtheVet SIGNED.pdf 1090-0008 Generic Clearance Request Form MyHealtheVet SIGNED IC Document
1090-0008 Survey Mapping Document (VHA) IA 30820.xlsx 1090-0008 Survey Mapping Document (VHA) IA 30820 IC Document

Information Collection (IC) Details

IC Title:	2020 002 Q_VAMyHealtheVet_Web_Browse_2020_1_17	Agency IC Tracking Number:	002

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	002	2020 002 Q_VAMyHealtheVet_Web_Browse_2020_1_17	2020 002 Q_VAMyHealtheVet_Web_Browse_2020_1_17.xlsx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,600	3,600
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
1090-0008 Generic Clearance Request Form MyHealtheVet SIGNED	1090-0008 Generic Clearance Request Form MyHealtheVet SIGNED.pdf	01/24/2020
1090-0008 Survey Mapping Document (VHA) IA 30820	1090-0008 Survey Mapping Document (VHA) IA 30820.xlsx	01/24/2020

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