Information Collection

Veteran Satisfaction Survey - THGP

IC 271209 under ICR 202409-2900-010 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-396 Veteran Satisfaction Survey - THGP	Form
Form 10-396 Veteran Satisfaction Survey Veteran Satisfaction Survey - THGP	Form
10-396 Veteran Satisfaction Survey Veteran Satisfaction Survey_Telehealth Grant Program_draft.docx	Form
10-396 Veteran Satisfaction Survey Veteran Satisfaction Survey_Telehealth Grant Program_draft.docx	Form

IC Title:

Agency IC Tracking Number:

VHA-2900-NEW

Is this a Common Form? No

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
Form	10-396				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

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
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].