Information Collection

Survey of Veteran Enrollees' Health and Use of Health Care

IC 28855 under ICR 202409-2900-001 · OMB 2900-0609.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2900-0609_VA Survey of Veteran Enrollees' Health and Use of Health Care_revised Sep 2024.docx	Other-Survey
Survey of Enrollees_2900-0609_Summary of Changes beginning in 2025.docx Summary of Changes to Survey of Enrollees_2900-0609_Sep 2024	IC Document

IC Title:

Agency IC Tracking Number:

2900-0609

Is this a Common Form? No

IC Status: Modified

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			2900-0609_VA Survey of Veteran Enrollees' Health and Use of Health Care_revised Sep 2024.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title: 97VA105, âConsolidated Data Information System-VA

FR Citation: 72 FR 46130

Number of Respondents: 40,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	40,000	-2,000	42,000
Annual IC Time Burden (Hours)	13,333	-667	14,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Summary of Changes to Survey of Enrollees_2900-0609_Sep 2024	Survey of Enrollees_2900-0609_Summary of Changes beginning in 2025.docx	10/04/2024

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