COVER Commission Focus Group Veterans Demographics Survey

Creating Options for Veterans Expedited Recovery (COVER) Commission Veterans Focus Groups: Mental Health Services Preferences and Utilization Data Collection

Documents and Forms

Document Name Document Type
COVER Comm_Veterans Demographics Survey_OMB passback revision_06172019_FINAL.docx Other-Survey
CARA Legislation_PL 114 198 Sect 931_COVER Commission.docx CARA Legislation_PL 114-198_Section 931_COVER Commission IC Document

Information Collection (IC) Details

IC Title:	COVER Commission Focus Group Veterans Demographics Survey	Agency IC Tracking Number:

Is this a Common Form? No		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-Survey			COVER Comm_Veterans Demographics Survey_OMB passback revision_06172019_FINAL.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
CARA Legislation_PL 114-198_Section 931_COVER Commission	CARA Legislation_PL 114 198 Sect 931_COVER Commission.docx	05/01/2019

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