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Federal forms, ICRs, and supporting documents

Information Collection

Primary Care Satisfaction Survey

IC 228035 under ICR 201404-2900-002 · OMB 2900-0769.

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

View Information Collection (IC)

Primary Care Satisfaction Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Patient Satisfaction Survey w Cover - VHA Pittsburgh 646 - Primary Care.pdf No   Printable Only

Health Health Care Services

 

5,760 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 5,760 0 5,760 0 0 0
Annual IC Time Burden (Hours) 192 0 192 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Primary Care Satisfaction Survey Generic Clearance Request - VHA Pittsburgh 646 - Primary Care.docx 08/25/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.