VHA Veteran Inpatient Services VEO Survey / VBA Contact Center

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⚠️ Notice: This information collection may be referencing outdated material.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
Inpatient_SurveyMockup_103118_v4.pdf Other-eSurvey
VBACC_SurveyMockup_10.31.18_V1.2.pdf Other-eSurvey
Inpatient_FastTrackClearance_10.23.18.docx VHA Veteran Inpatient Services VEO Survey IC Document
VBACC_FastTrackClearance_10.30.18.docx VBA Contact Center IC Document
Inpatient Sampling Plan_102318.docx Inpatient Sampling IC Document
VBA CC Sampling Plan_10.30.18.docx VBA Contact Center Sampling Plan IC Document
Inpatient_EmailsMockup_102518_v4.pdf Inpatient Email Mock Up IC Document
VBACC_EmailMockup_10.31.18_V1.2.pdf VBA Contact Center Email Mock-Up IC Document

Information Collection (IC) Details

IC Title:	VHA Veteran Inpatient Services VEO Survey / VBA Contact Center	Agency IC Tracking Number:

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-eSurvey			Inpatient_SurveyMockup_103118_v4.pdf	TBD	Yes	Yes	Fillable Fileable
Other-eSurvey			VBACC_SurveyMockup_10.31.18_V1.2.pdf	TBD	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 236,112	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	236,112	236,112
Annual IC Time Burden (Hours)	7,870	7,870
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
VHA Veteran Inpatient Services VEO Survey	Inpatient_FastTrackClearance_10.23.18.docx	11/01/2018
VBA Contact Center	VBACC_FastTrackClearance_10.30.18.docx	11/01/2018
Inpatient Sampling	Inpatient Sampling Plan_102318.docx	11/01/2018
VBA Contact Center Sampling Plan	VBA CC Sampling Plan_10.30.18.docx	11/01/2018
Inpatient Email Mock Up	Inpatient_EmailsMockup_102518_v4.pdf	11/01/2018
VBA Contact Center Email Mock-Up	VBACC_EmailMockup_10.31.18_V1.2.pdf	11/01/2018

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