Virtual Nursing Visits to Evaluate Blood Pressure - Provider & Clinician Opinion

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⚠️ Notice: This information collection may be referencing outdated material.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
VA Video Connect Patient Questions 28Mar18.docx To be determined Other-User Inquiry
VA Video Connect Clinician Questions.docx To be determined Other-User Inquiry
Generic Clearance Submission_Virtual Nursing Visits_Carrico 28Mar18.doc Generic Request_Virtual Nursing Visits IC Document

Information Collection (IC) Details

IC Title:	Virtual Nursing Visits to Evaluate Blood Pressure - Provider & Clinician Opinion	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-User Inquiry			VA Video Connect Clinician Questions.docx	To be determined	Yes	Yes	Fillable Printable
Other-User Inquiry			VA Video Connect Patient Questions 28Mar18.docx	To be determined	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 70	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	70	70
Annual IC Time Burden (Hours)	18	18
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Request_Virtual Nursing Visits	Generic Clearance Submission_Virtual Nursing Visits_Carrico 28Mar18.doc	04/12/2018

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