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pdfOMB No. 2900-0770
Estimated Burden: 2 min.
Tele-Dermatology Imaging
Satisfaction Survey
The Paperwork Reduction Act of 1995: This information is collected in accordance with section
3507 of the Paperwork Reduction Act of 1995. Accordingly, we may not conduct or sponsor and
you are not required to respond to, a collection of information unless it displays a valid OMB
number. We anticipate that the time expended by all individuals who complete this survey will
average 2 minutes. This includes the time it will take to follow instructions, gather the necessary
facts and respond to questions asked. Customer satisfaction is used to gauge customer
perceptions of VA services as well as customer expectations and desires. The results of this
survey will lead to improvements in the quality of service delivery to our Veterans and patients.
Participation in this survey is voluntary and failure to respond will have no impact on benefits to
which you may be entitled.
VA Form
JAN 2014
10-211016
1
OMB No. 2900-0770
Estimated Burden: 2 min.
VA Form
JAN 2014
10-211016
2
| File Type | application/pdf |
| Author | mercincavage_l |
| File Modified | 2014-01-28 |
| File Created | 2014-01-28 |