Shared Decision Making

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⚠️ Notice: This information collection may be referencing outdated material.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
Veteran SDM Questionnaire 03March2016.docx Other-Veteran Telephone Script
Caregiver SDM Questionnaire 03March2016.docx Other-Caregiver Telephone Script
Glossary - short 090215.docx Other-Glossary
Phone Interview Contact Script 082515.docx Other-Phone Interview Script
VA Shared Decision Making Generic Clearance - Taylor 111615.docx Generic Clearance Request IC Document

Information Collection (IC) Details

IC Title:	Shared Decision Making	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Veteran Telephone Script	Veteran SDM Questionnaire 03March2016.docx	No	Paper Only
Other-Caregiver Telephone Script	Caregiver SDM Questionnaire 03March2016.docx	No	Paper Only
Other-Glossary	Glossary - short 090215.docx	No	Paper Only
Other-Phone Interview Script	Phone Interview Contact Script 082515.docx	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Request	VA Shared Decision Making Generic Clearance - Taylor 111615.docx	03/10/2016

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