Used to determine if a malpractice
payment is related to substandard care, professional incompetence
or misconduct as well as to systematically screen and review
qualifications and other credentials such as licensure, education,
training, past experience, current competence and health status of
doctors, dentists and other healthcare professionals.
Program office anticipates
reduced use of this survey instrument.
$0
No
No
No
No
No
Uncollected
Crystal Rennie 202 632-7492
crystal.rennie@va.gov
No
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.