Generic Veterans Health Administration Customer Satisfaction Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0570 can be found here:

Documents and Forms

Document Name Document Type
My HealtheVet Pilot Survey Veteran Questionnaire 2007[1].doc www.myhealth.va.gov Other-Survey
My HealtheVet Survey Questions for SHEP 2007[1].doc www.myhealth.va.gov Other-Survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Generic Veterans Health Administration Customer Satisfaction Surveys	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			My HealtheVet Pilot Survey Veteran Questionnaire 2007[1].doc	www.myhealth.va.gov	Yes	Yes	Fillable Fileable
Other-Survey			My HealtheVet Survey Questions for SHEP 2007[1].doc	www.myhealth.va.gov	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 531,144	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,074,901	1,074,901
Annual IC Time Burden (Hours)	130,644	130,644
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.