OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

VHA Pallative Care Telehealth Appointments / Mental Health Veterans Survey

IC 228034 under ICR 201404-2900-002 · OMB 2900-0769.

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

View Information Collection (IC)

VHA Pallative Care Telehealth Appointments / Mental Health Veterans Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Usability scale Pallative System Usability Scale and Demographic Qs_UX Pall Care UPDATED UNION OMB.pdf TBD Yes No Fillable Printable
Other-Survey MH Veterans Satisfaction Survey.docx No   Paper Only

Health Health Care Services

 

10,010 0
   
Individuals or Households
 
   0 %

  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 10,010 0 10,010 0 0 0
Annual IC Time Burden (Hours) 2,503 0 2,503 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Veterans' and Providers' User Experience of Palliative Care Telehealth Appointments Generic Clearance Submission_Telehealth Appts.doc 08/24/2017
Office of Mental Health Veteran Satisfaction Survey MH Veterans Satisfaction Generic Request_052417.docx 08/24/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.