Understanding Patient Perceptions of Access in VISN 22

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⚠️ Notice: This information collection may be referencing outdated material.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
Patient_Perceptions_of_Access_Interview_Guide_clean_ 1.10.18 le.docx Other-Interview Questions
VA Generic Fast-Track Clearance Request_Stockdale_clean_1.17.18 le.docx Generic Request_VISN 22 Patient Perceptions IC Document
VAIL_2.0 QI memo for patient focus group_3_20_17_Dresselhaus.pdf Memo IC Document
Interview_Invitation_Letter_final_clean_ 1.10.18 le.docx Invitation Letter IC Document
Question and Answer Addendum_Stockdale_clean_1.10.18_le.docx Q&A IC Document

Information Collection (IC) Details

IC Title:	Understanding Patient Perceptions of Access in VISN 22	Agency IC Tracking Number:	2900-0770

IC Status: New

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-Interview Questions			Patient_Perceptions_of_Access_Interview_Guide_clean_ 1.10.18 le.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	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	50	50
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Request_VISN 22 Patient Perceptions	VA Generic Fast-Track Clearance Request_Stockdale_clean_1.17.18 le.docx	03/29/2018
Memo	VAIL_2.0 QI memo for patient focus group_3_20_17_Dresselhaus.pdf	02/27/2018
Invitation Letter	Interview_Invitation_Letter_final_clean_ 1.10.18 le.docx	02/27/2018
Q&A	Question and Answer Addendum_Stockdale_clean_1.10.18_le.docx	02/27/2018

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