Generic Veterans Health Administration Customer Satisfaction Surveys

ICR 200304-2900-006

OMB: 2900-0570

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
2900-0570 200304-2900-006
Historical Active 200202-2900-015
VA
Generic Veterans Health Administration Customer Satisfaction Surveys
Extension without change of a currently approved collection   No
Regular
Approved without change 06/26/2003
Retrieve Notice of Action (NOA) 04/25/2003
Approved with the following terms: 1. VA will track all surveys developed with the pre-approved questions and report the actual burden numbers in the annual information collection budget. 2. Surveys developed under this generic clearance number using questions not pre-approved in this submission must be submitted to OMB for review.
  Inventory as of this Action Requested Previously Approved
07/31/2006 07/31/2006 06/30/2003
377,541 0 338,780
108,617 0 75,069
0 0 0

The information gathered will measure the efficacy of process improvement interventions designed around areas of poor performance highlighted in the centrally conducted national VHA Veteran Healthcare Satisfaction Surveys.

None
None


No

1
IC Title Form No. Form Name
Generic Veterans Health Administration Customer Satisfaction Surveys

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 377,541 338,780 0 0 38,761 0
Annual Time Burden (Hours) 108,617 75,069 0 0 33,548 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/25/2003


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