Non-Substantive Change Request Memorandum - 2900-0764 - DPSS - signed Oct 2024

Department of
Veterans Affairs

Memorandum

Date:

October 15, 2024

From:

Christine L. LaMarre, DDS
Assistant Under Secretary for Health for Dentistry, VHA Office of Dentistry

Subject:

Non-Substantive Changes to OMB Control No. 2900-0764

To:

VA Desk Officer, Office of Management & Budget (OMB)

Cc:

VA PRA Clearance Officer, Maribel Aponte
Data Governance & Analytics, Office of Enterprise and Integration

The following are updates and supplementary information for OMB Control No. 2900-0764:
The Department of Veterans Affairs (VA) Veterans Health Administration (VHA) has been
working toward an electronic capability for the Survey of Healthcare Experiences of Patients
(SHEP) -- Dental Care Patient Satisfaction Survey (VA Form 10-10070). VA is prepared to
implement this additional mode of collecting the survey information in 2024.
a. Updates: The program office has made updates to the survey, VA Form 10-10070, as
described below:
i.
ii.
iii.

The survey will be available through an additional mode utilizing a web-based
access system.
There are no changes to the questions currently approved for this survey.
There are no changes to the currently approved burden hours.

b. Supplementary Documents:
i.
VA Form 10070 -- current
ii.
VA Form 10070 – web version (screen shots)
iii.
The updated Supporting Statement A also is included, which describes the new
online capability for administering this survey.

c. New Information:
i.
No new information will be collected via the electronic version of the survey. The
questions in VA Form 10-10070 will remain the same as those approved for the
current survey.

CHRISTINE
LAMARRE

Digitally signed by
CHRISTINE LAMARRE
Date: 2024.10.15 16:42:43
-07'00'

___________________________________________

Christine L. LaMarre, DDS
Assistant Under Secretary for Health for Dentistry