OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Clearance for A-11 Section 280 Improving Customer Experience Information Collection

ICR 202503-2900-010 · OMB 2900-0876 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 2900-0876 ECCC – V ECCC – VA Loan Guaranty Form and Instruction Unchanged Available
Form 2900-0876 ECCC – V ECCC – VA Loan Guaranty Form and Instruction Unchanged Missing upstream
Form Telehealth Emergen Telehealth Emergency Medicine Survey Update Form and Instruction Unchanged Available
Form Telehealth Emergen Telehealth Emergency Medicine Survey Update Form and Instruction Unchanged Repair queued
Form 2900-0876 Office of Community Care – IVC Survey Collection Form and Instruction Unchanged Available
Form 2900-0876 Office of Community Care – IVC Survey Collection Form and Instruction Unchanged Repair queued
Form 2900-0876 ECCC – IVC VA Health Connect Form and Instruction Unchanged Available
Form 2900-0876 ECCC – IVC VA Health Connect Form and Instruction Unchanged Repair queued
Form 2900-0876 VBA Education Survey Form and Instruction Unchanged Available
Form 2900-0876 VBA Education Survey Form and Instruction Unchanged Missing upstream
Form VFCE VEAC Email Su Veterans Family and Community Engagement (VFCE) Veterans Engagement Action Center (VEAC) Email & Exit Surveys Form and Instruction Unchanged Available
Form VFCE VEAC Email Su Veterans Family and Community Engagement (VFCE) Veterans Engagement Action Center (VEAC) Email & Exit Surveys Form and Instruction Unchanged Repair queued
Form Annie Text Messagi Annie Text Messaging Survey Question Changes Form and Instruction Unchanged Available
Form Annie Text Messagi Annie Text Messaging Survey Question Changes Form and Instruction Unchanged Repair queued
Form OSDBU CS Wireframe Office of Small & Disadvantaged Business Utilization (OSDBU) Customer Service & Lunch "N" Learn Survey Updates Form and Instruction Unchanged Available
Form OSDBU CS Wireframe Office of Small & Disadvantaged Business Utilization (OSDBU) Customer Service & Lunch "N" Learn Survey Updates Form and Instruction Unchanged Repair queued
Form OSDBU IVR Wirefram Enterprise Contact Center Council (ECCC) Office of Small & Disadvantaged Business Utilization (OSDBU) Interactive Voice Response (IVR) Survey Form and Instruction Unchanged Available
Form OSDBU IVR Wirefram Enterprise Contact Center Council (ECCC) Office of Small & Disadvantaged Business Utilization (OSDBU) Interactive Voice Response (IVR) Survey Form and Instruction Unchanged Repair queued
Form Personalized Caree Personalized Career Planning and Guidance (PGPC) Survey Form and Instruction Unchanged Available
Form Personalized Caree Personalized Career Planning and Guidance (PGPC) Survey Form and Instruction Unchanged Repair queued
Form Wireframe Template Sturgis Rally VetFest 2024 Mini Registration Form and Instruction Unchanged Available
Form Wireframe Template Sturgis Rally VetFest 2024 Mini Registration Form and Instruction Unchanged Repair queued
Form Healthy Teaching K Healthy Teaching Kitchen Survey Form and Instruction Unchanged Available
Form Healthy Teaching K Healthy Teaching Kitchen Survey Form and Instruction Unchanged Repair queued
Form 2900-0876 After Vi After Visit Summary Survey Form and Instruction Unchanged Available
Form 2900-0876 After Vi After Visit Summary Survey Form and Instruction Unchanged Missing upstream
Form 2900-0876 MyHealth MyHealtheVet and Oracle Health Survey Form and Instruction Unchanged Available
Form 2900-0876 MyHealth MyHealtheVet and Oracle Health Survey Form and Instruction Unchanged Repair queued
Form ECCC Member Servic Member Services Contact Center Survey Form and Instruction Unchanged Available
Form ECCC Member Servic Member Services Contact Center Survey Form and Instruction Unchanged Repair queued
Form 2023-03-08 Compens VBA Compensation Survey - Increase Burden Form and Instruction Unchanged Repair queued
Form 2023-03-08 Compens VBA Compensation Survey - Increase Burden Form and Instruction Unchanged Repair queued
Form Survivor Survey survivor Survey Form and Instruction Unchanged Available
Form Survivor Survey survivor Survey Form and Instruction Unchanged Repair queued
Form 2900-0876 Teleheal Telehealth Store and Forward Result Form and Instruction Unchanged Available
Form 2900-0876 Teleheal Telehealth Store and Forward Result Form and Instruction Unchanged Repair queued
Form ECCC Vet Center Wi ECCC Vet Center Form and Instruction Unchanged Available
Form ECCC Vet Center Wi ECCC Vet Center Form and Instruction Unchanged Repair queued
Form Participating VR&E VBA Veteran Readiness and Employment Survey Form and Instruction Unchanged Repair queued
Form Participating VR&E VBA Veteran Readiness and Employment Survey Form and Instruction Unchanged Repair queued
Form PCT survey Public Contact Team Survey Form and Instruction Unchanged Available
Form PCT survey Public Contact Team Survey Form and Instruction Unchanged Missing upstream
Form Indiana WF 1.12.24 Indiana Survey Form and Instruction Unchanged Available
Form Indiana WF 1.12.24 Indiana Survey Form and Instruction Unchanged Repair queued
Form 2900-0876 Clinical Clinical Screening Tool Survey Form and Instruction Unchanged Available
Form 2900-0876 Clinical Clinical Screening Tool Survey Form and Instruction Unchanged Repair queued
Form VIP Bootcamp Satis VIP Bootcamp Satisfaction Survey Form and Instruction Unchanged Available
Form VIP Bootcamp Satis VIP Bootcamp Satisfaction Survey Form and Instruction Unchanged Repair queued
Form Compassionate Cont Compassionate Contact Corps Survey Form and Instruction Unchanged Available
Form Compassionate Cont Compassionate Contact Corps Survey Form and Instruction Unchanged Repair queued
Form MOVE! Maintenance MOVE! Maintenance Pilot Program Survey Form and Instruction Unchanged Available
Form MOVE! Maintenance MOVE! Maintenance Pilot Program Survey Form and Instruction Unchanged Repair queued
Form VSDHF Engagement S VSDHF Engagement Survey Form and Instruction Unchanged Repair queued
Form VSDHF Engagement S VSDHF Engagement Survey Form and Instruction Unchanged Repair queued
Form 2900-0876 Telemedi Telemedicine Form and Instruction Unchanged Repair queued
Form 2900-0876 Telemedi Telemedicine Form and Instruction Unchanged Repair queued
Form Anesthesia Patient Anesthesia Patient Satisfaction Survey Form and Instruction Unchanged Repair queued
Form Anesthesia Patient Anesthesia Patient Satisfaction Survey Form and Instruction Unchanged Repair queued
Form NFS Wireframe Nutrition & Food Service(NFS) Inpatient Survey Form and Instruction Unchanged Available
Form NFS Wireframe Nutrition & Food Service(NFS) Inpatient Survey Form and Instruction Unchanged Repair queued
Form Homelessness WF 6. Homelessness Survey Form and Instruction Unchanged Available
Form Homelessness WF 6. Homelessness Survey Form and Instruction Unchanged Missing upstream
Form VRCN Wireframe 6.1 VetResources Community Network (VRCN) Survey Form and Instruction Unchanged Repair queued
Form VRCN Wireframe 6.1 VetResources Community Network (VRCN) Survey Form and Instruction Unchanged Repair queued
Form ECCC - VET HOME Su Enterprise Contact Center Council (ECCC) - Veterans Exposure Team-Health Outcomes Military Exposures (VET-HOME) Survey Form and Instruction Unchanged Repair queued
Form ECCC - VET HOME Su Enterprise Contact Center Council (ECCC) - Veterans Exposure Team-Health Outcomes Military Exposures (VET-HOME) Survey Form and Instruction Unchanged Repair queued
Form CLC WF with footer Community Living Center (CLC) Survey Form and Instruction Unchanged Available
Form CLC WF with footer Community Living Center (CLC) Survey Form and Instruction Unchanged Repair queued
Form Northern Arizona D Northern Arizona Dental Service survey Form and Instruction Unchanged Available
Form Northern Arizona D Northern Arizona Dental Service survey Form and Instruction Unchanged Missing upstream
Form Under 40 Trust WF Under 40 Trust Project Form and Instruction Unchanged Available
Form Under 40 Trust WF Under 40 Trust Project Form and Instruction Unchanged Repair queued
Form Solid Start Survey VA Solid Start Survey Form and Instruction Unchanged Available
Form Solid Start Survey VA Solid Start Survey Form and Instruction Unchanged Repair queued
Form Promise to Address Promise to Address Comprehensive Toxics (PACT) Act Outreach survey Form and Instruction Unchanged Repair queued
Form Promise to Address Promise to Address Comprehensive Toxics (PACT) Act Outreach survey Form and Instruction Unchanged Repair queued
Form Compensation Surve VBA Compensation Survey Form and Instruction Unchanged Available
Form Compensation Surve VBA Compensation Survey Form and Instruction Unchanged Repair queued
Form Military Exposures Military Exposure Survey Form and Instruction Unchanged Available
Form Military Exposures Military Exposure Survey Form and Instruction Unchanged Missing upstream
Form MOVE! Maintenance MOVE! Maintenance Pilot Program Form and Instruction Unchanged Repair queued
Form MOVE! Maintenance MOVE! Maintenance Pilot Program Form and Instruction Unchanged Repair queued
Form Long Covid Survey Long COVID Surveys Form and Instruction Unchanged Available
Form Long Covid Survey Long COVID Surveys Form and Instruction Unchanged Repair queued
Form VA.gov VFS Questio VA.gov A-11 Surveys Form and Instruction Unchanged Available
Form VA.gov VFS Questio VA.gov A-11 Surveys Form and Instruction Unchanged Repair queued
Form Annie Text Messagi Annie Text Messaging Survey Form and Instruction Unchanged Repair queued
Form Annie Text Messagi Annie Text Messaging Survey Form and Instruction Unchanged Missing upstream
Form VRE CH31 - Learnin VBA Veterans Readiness and Employment (Chapter 31) Surveys Form and Instruction Unchanged Available
Form VRE CH31 - Learnin VBA Veterans Readiness and Employment (Chapter 31) Surveys Form and Instruction Unchanged Repair queued
2900-0876 Non-Sub Change Request - EO 14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-03-21 Available
2900-0876 Non-Sub Change Request - EO 14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-03-14 Repair queued
30-day FRN 2900-0876.pdf Supplementary Document Uploaded 2022-12-30 Available
30-day FRN 2900-0876.pdf Supplementary Document Uploaded 2022-12-30 Repair queued
60 Day FRN.pdf Supplementary Document Uploaded 2022-12-21 Available
60 Day FRN.pdf Supplementary Document Uploaded 2022-12-21 Repair queued
A-11 30-day FRN_ 2900-0876 17Oct2022.docx Supplementary Document Uploaded 2022-10-17 Available
A-11 30-day FRN_ 2900-0876 17Oct2022.docx Supplementary Document Uploaded 2022-10-17 Missing upstream
A-11 60-day FRN_ 2900-0876 17Oct2022.docx Supplementary Document Uploaded 2022-10-17 Repair queued
A-11 60-day FRN_ 2900-0876 17Oct2022.docx Supplementary Document Uploaded 2022-10-17 Repair queued
2900-0876 SSA (Final 2022-02-01).docx Supporting Statement A Uploaded 2023-02-01 Available
2900-0876 SSA (Final 2022-02-01).docx Supporting Statement A Uploaded 2023-02-01 Repair queued
A-11 Fast-Track Clearance Request Template.docx Supplementary Document Uploaded 2020-03-13 Available
A-11 Fast-Track Clearance Request Template.docx Supplementary Document Uploaded 2020-03-13 Repair queued
Supporting Statement B for Agencies_A 11 Section 280 Improving Customer Experience.docx Supporting Statement B Uploaded 2022-10-13 Available
Supporting Statement B for Agencies_A 11 Section 280 Improving Customer Experience.docx Supporting Statement B Uploaded 2022-10-13 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
274354 ECCC – VA Loan Guaranty Form and Instruction Unchanged
274354 ECCC – VA Loan Guaranty Form and Instruction Unchanged
274197 Telehealth Emergency Medicine Survey Update Form and Instruction Unchanged
274197 Telehealth Emergency Medicine Survey Update Form and Instruction Unchanged
274194 Veteran Transportation Surveys Other-Survey Instrument Unchanged
273946 Office of Community Care – IVC Survey Collection Form and Instruction Unchanged
273946 Office of Community Care – IVC Survey Collection Form and Instruction Unchanged
273856 ECCC – IVC VA Health Connect Form and Instruction Unchanged
273856 ECCC – IVC VA Health Connect Form and Instruction Unchanged
273754 VBA Education Survey Form and Instruction Unchanged
273754 VBA Education Survey Form and Instruction Unchanged
273477 VA OIG Viewer Interest Project Other-Survey Instrument Unchanged
272998 Veterans Family and Community Engagement (VFCE) Veterans Engagement Action Center (VEAC) Email & Exit Surveys Form and Instruction Unchanged
272998 Veterans Family and Community Engagement (VFCE) Veterans Engagement Action Center (VEAC) Email & Exit Surveys Form and Instruction Unchanged
272962 Annie Text Messaging Survey Question Changes Form and Instruction Unchanged
272962 Annie Text Messaging Survey Question Changes Form and Instruction Unchanged
272799 Office of Small & Disadvantaged Business Utilization (OSDBU) Customer Service & Lunch "N" Learn Survey Updates Form and Instruction Unchanged
272799 Office of Small & Disadvantaged Business Utilization (OSDBU) Customer Service & Lunch "N" Learn Survey Updates Form and Instruction Unchanged
272611 VHA Community Living Center - Add SCI/D question Other-Survey Instrument Unchanged
272507 VHA ALS Customer Experience Survey Other-Survey Instrument Unchanged
272500 Beneficiary Travel Self Service System (BTSSS) Survey Question updates Other-Survey Instrument Unchanged
272432 Enterprise Contact Center Council (ECCC) Office of Small & Disadvantaged Business Utilization (OSDBU) Interactive Voice Response (IVR) Survey Form and Instruction Unchanged
272432 Enterprise Contact Center Council (ECCC) Office of Small & Disadvantaged Business Utilization (OSDBU) Interactive Voice Response (IVR) Survey Form and Instruction Unchanged
272393 Personalized Career Planning and Guidance (PGPC) Survey Form and Instruction Unchanged
272393 Personalized Career Planning and Guidance (PGPC) Survey Form and Instruction Unchanged
269874 Annie Text Messaging Survey Question Changes Other-Survey Instrument Unchanged
269793 Sturgis Rally VetFest 2024 Mini Registration Form and Instruction Unchanged
269793 Sturgis Rally VetFest 2024 Mini Registration Form and Instruction Unchanged
269523 Healthy Teaching Kitchen Survey Form and Instruction Unchanged
269523 Healthy Teaching Kitchen Survey Form and Instruction Unchanged
269404 After Visit Summary Survey Form and Instruction Unchanged
269404 After Visit Summary Survey Form and Instruction Unchanged
269189 MyHealtheVet and Oracle Health Survey Form and Instruction Unchanged
269189 MyHealtheVet and Oracle Health Survey Form and Instruction Unchanged
269049 Member Services Contact Center Survey Form and Instruction Unchanged
269049 Member Services Contact Center Survey Form and Instruction Unchanged
268403 VBA Compensation Survey - Increase Burden Form and Instruction Unchanged
268403 VBA Compensation Survey - Increase Burden Form and Instruction Unchanged
268074 Blind and Low Vision Rehabilitation Survey Other-Survey Instrument Unchanged
267667 survivor Survey Form and Instruction Unchanged
267667 survivor Survey Form and Instruction Unchanged
267302 Nutrition and Food Service Inpatient Survey - Updated Question Other-Survey Instrument Unchanged
266993 VEAC/Outreach Naming Survey Other-Survey Instrument Unchanged
266324 Telehealth Store and Forward Result Form and Instruction Unchanged
266324 Telehealth Store and Forward Result Form and Instruction Unchanged
266009 ECCC Vet Center Form and Instruction Unchanged
266009 ECCC Vet Center Form and Instruction Unchanged
265731 VBA Veteran Readiness and Employment Survey Form and Instruction Unchanged
265731 VBA Veteran Readiness and Employment Survey Form and Instruction Unchanged
265530 VFCE VEAC Survey - Updated Trust Question Other-Survey Instrument Unchanged
265526 Community Living Centers (CLC) Survey-Updated trust question Other-Survey Instrument Unchanged
265229 Public Contact Team Survey Form and Instruction Unchanged
265229 Public Contact Team Survey Form and Instruction Unchanged
264539 Indiana Survey Form and Instruction Unchanged
264539 Indiana Survey Form and Instruction Unchanged
264139 Spanish Benefits Letter Survey Other-Survey Instrument Unchanged
262871 Clinical Screening Tool Survey Form and Instruction Unchanged
262871 Clinical Screening Tool Survey Form and Instruction Unchanged
262578 VIP Bootcamp Satisfaction Survey Form and Instruction Unchanged
262578 VIP Bootcamp Satisfaction Survey Form and Instruction Unchanged
262424 Compassionate Contact Corps Survey Form and Instruction Unchanged
262424 Compassionate Contact Corps Survey Form and Instruction Unchanged
262422 Support Staff Post Veterans Experience Action Center (VEAC) Other-Survey Instrument Unchanged
262120 Ensuring Awareness of Benefits and Services of NCA Other-Survey Instrument Unchanged
261945 Beneficiary Travel Self Service System (BTSSS) Survey Other-Survey Instrument Unchanged
261942 MOVE! Maintenance Pilot Program Survey Form and Instruction Unchanged
261942 MOVE! Maintenance Pilot Program Survey Form and Instruction Unchanged
261804 Outpatient-Labs and Imaging - Add Mammography Questions Other-Survey Instrument Unchanged
261791 VSDHF Engagement Survey Form and Instruction Unchanged
261791 VSDHF Engagement Survey Form and Instruction Unchanged
261780 Telemedicine Form and Instruction Unchanged
261780 Telemedicine Form and Instruction Unchanged
261480 Anesthesia Patient Satisfaction Survey Form and Instruction Unchanged
261480 Anesthesia Patient Satisfaction Survey Form and Instruction Unchanged
261190 Clinical Contact Center Survey-Update Burden Other-Survey Instrument Unchanged
260965 Nutrition & Food Service(NFS) Inpatient Survey Form and Instruction Unchanged
260965 Nutrition & Food Service(NFS) Inpatient Survey Form and Instruction Unchanged
260783 Homelessness Survey Form and Instruction Unchanged
260783 Homelessness Survey Form and Instruction Unchanged
260683 VetResources Community Network (VRCN) Survey Form and Instruction Unchanged
260683 VetResources Community Network (VRCN) Survey Form and Instruction Unchanged
260557 Enterprise Contact Center Council (ECCC) - Veterans Exposure Team-Health Outcomes Military Exposures (VET-HOME) Survey Form and Instruction Unchanged
260557 Enterprise Contact Center Council (ECCC) - Veterans Exposure Team-Health Outcomes Military Exposures (VET-HOME) Survey Form and Instruction Unchanged
260348 Community Living Center (CLC) Survey Form and Instruction Unchanged
260348 Community Living Center (CLC) Survey Form and Instruction Unchanged
260108 Northern Arizona Dental Service survey Form and Instruction Unchanged
260108 Northern Arizona Dental Service survey Form and Instruction Unchanged
259926 Under 40 Trust Project Form and Instruction Unchanged
259926 Under 40 Trust Project Form and Instruction Unchanged
259840 VA Solid Start Survey Form and Instruction Unchanged
259840 VA Solid Start Survey Form and Instruction Unchanged
259612 Promise to Address Comprehensive Toxics (PACT) Act Outreach survey Form and Instruction Unchanged
259612 Promise to Address Comprehensive Toxics (PACT) Act Outreach survey Form and Instruction Unchanged
259047 VBA Compensation Survey Form and Instruction Unchanged
259047 VBA Compensation Survey Form and Instruction Unchanged
259032 Military Exposure Survey Form and Instruction Unchanged
259032 Military Exposure Survey Form and Instruction Unchanged
258896 MOVE! Maintenance Pilot Program Form and Instruction Unchanged
258896 MOVE! Maintenance Pilot Program Form and Instruction Unchanged
258567 Long COVID Surveys Form and Instruction Unchanged
258567 Long COVID Surveys Form and Instruction Unchanged
258501 VA.gov A-11 Surveys Form and Instruction Unchanged
258501 VA.gov A-11 Surveys Form and Instruction Unchanged
258478 Annie Text Messaging Survey Form and Instruction Unchanged
258478 Annie Text Messaging Survey Form and Instruction Unchanged
258284 VBA Veterans Readiness and Employment (Chapter 31) Surveys Form and Instruction Unchanged
258284 VBA Veterans Readiness and Employment (Chapter 31) Surveys Form and Instruction Unchanged
ICR Details
StatusActive
Agency/SubagencyVA
OMB Control No2900-0876
Type of Information CollectionNo material or nonsubstantive change to a currently approved collection
Previous ICR Reference No202210-2900-003
Agency Tracking NoVEO A-11 0002
Date Submitted to OIRA2025-03-19
Requested Expiration Date1969-12-31