PTSD Family Caregiver Feedback/ARCH Focus Group/VA Courtesy Standards/PTSD Coach (Phone) Apps Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCA, VBA, VHA)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Document Name Document Type
Form VA Form 10-0495 PTSD Family Caregiver Feedback/ARCH Focus Group/VA Courtesy Standards/PTSD Coach (Phone) Apps Survey Form
ARCH_Focus_Group_Telephone_Script_(2)[1].docx Other-Telephone Script
ARCH_Focus_Group_Discussion_Guide1.pdf Instruction
Phone_Apps_Focus_Group_Guide_and_Script_(v4)[1].docx Other-Focus Group Guide and Script
ARCH FocusGroup Letter.docx Other-Notification Letter
VA Form 10-0495 Understanding PTSD for Family Caregivers: Feedback Surve PTSD and Family Caregivers Survey 10-0495.docx slu.qualtrics.com/SE/?SID=SV 7P6Zja6FxuVnhwF Form
VA Form 10-0497 VA Courtesy Standards - The Golden Rule Approach Veteran VA Courtesy Standards-Golden Rule Approach 10-0497.doc Form
VA Form 10-0496 PTSD Coach App Survey PTSD Phone Apps Survey 10-0496_v3.pdf Form
VA Form 10-0496a Phone Apps Focus Group Demographic Questionnaire Phone Apps_Focus Group Demographic Questionnaire (v5)(A).docx Form
Generic_Request_PTSD_Caregiver_Training (v2).docx Feedback on Caregiver PTSD Training IC Document
Generic_Request_ARCH_FocusGroup[1].docx Project ARCH Focus Group IC Document
Generic_Request_VA Courtesy Standards.docx VA Courtesy Standards-Golden Rule Approach IC Document
PTSD_Phone_Apps_Focus_Group-Survey_Submission_(v3).docx PTSD Phone Apps Focus Grp and Survey IC Document

Information Collection (IC) Details

IC Title:	PTSD Family Caregiver Feedback/ARCH Focus Group/VA Courtesy Standards/PTSD Coach (Phone) Apps Survey	Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 1320.8(d)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 10-0495	Understanding PTSD for Family Caregivers: Feedback Survey	PTSD and Family Caregivers Survey 10-0495.docx	https://slu.qualtrics.com/SE/?SID=SV 7P6Zja6FxuVnhwF	Yes	Yes	Fillable Fileable
Other-Telephone Script			ARCH_Focus_Group_Telephone_Script_(2)[1].docx		No		Paper Only
Instruction			ARCH_Focus_Group_Discussion_Guide1.pdf		No		Paper Only
Form	VA Form 10-0497	VA Courtesy Standards - The Golden Rule Approach Veteran Feedback Form	VA Courtesy Standards-Golden Rule Approach 10-0497.doc		No		Paper Only
Form	VA Form 10-0496	PTSD Coach App Survey	PTSD Phone Apps Survey 10-0496_v3.pdf		No		Paper Only
Other-Focus Group Guide and Script			Phone_Apps_Focus_Group_Guide_and_Script_(v4)[1].docx		No		Paper Only
Other-Notification Letter			ARCH FocusGroup Letter.docx		No		Paper Only
Form	VA Form 10-0496a	Phone Apps Focus Group Demographic Questionnaire	Phone Apps_Focus Group Demographic Questionnaire (v5)(A).docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,420	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	4,420	4,420
Annual IC Time Burden (Hours)	1,353	1,353
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Feedback on Caregiver PTSD Training	Generic_Request_PTSD_Caregiver_Training (v2).docx	12/06/2012
Project ARCH Focus Group	Generic_Request_ARCH_FocusGroup[1].docx	12/10/2012
VA Courtesy Standards-Golden Rule Approach	Generic_Request_VA Courtesy Standards.docx	12/04/2012
PTSD Phone Apps Focus Grp and Survey	PTSD_Phone_Apps_Focus_Group-Survey_Submission_(v3).docx	12/11/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.