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Federal forms, ICRs, and supporting documents

Information Collection

Amputation System of Care Veteran Experience Survey

IC 278843 under ICR 202508-2900-010 · OMB 2900-0876.

Documents and Forms
Document Name
Document Type
Other-Survey Instrument
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Amputation System of Care Veteran Experience Survey 2900-0876 amputation
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Instrument Amputation System of Care Survey Wireframe_new.docx Yes Yes Fillable Fileable

Health Health Care Services

Veterans, Dependents of Veterans, and Veteran Beneficiaries  86 FR 6992

2,000 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,000 0 2,000 0 0 0
Annual IC Time Burden (Hours) 167 0 167 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
A-11 Fast Track Clearance Template Amputation System of Care A-11 Fast-Track Clearance Request Template 2025-12-17 (Amputation System of Care).docx 01/22/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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