Generic Veterans Health Administration Customer Satisfaction Surveys

Generic Veterans Health Administration Customer Satisfaction Survey - Care Coordination Home Telehealth (CCHT)

Documents and Forms

Document Name Document Type
CCHT Electronic Survey Questions.doc To be determine Other-survey

Information Collection (IC) Details

IC Title:	Generic Veterans Health Administration Customer Satisfaction Surveys	Agency IC Tracking Number:	2900-0570

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			CCHT Electronic Survey Questions.doc	To be determine	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 885,797	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Previously Approved
Annual Number of Responses for this IC	885,797	885,797
Annual IC Time Burden (Hours)	125,347	125,347
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.