Information Collection

VA Suicide Prevention 2.0 Program - Community Opinion Survey

IC 249496 under ICR 202505-2900-005 · OMB 2900-0911.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2900-0911_Suicide Prev 2.0 Prog - Community Opinion Survey (COS)_updated Jun 2025.pdf	Other-Survey
2900-0911_Suicide Prev 2.0 Prog - Community Opinion Survey (COS)_updated Jun 2025.pdf	Other-Survey

IC Title:

Agency IC Tracking Number:

VHA-2900-0911

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					Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 44,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	44,000	44,000
Annual IC Time Burden (Hours)	11,000	11,000
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.

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