Clearance for A-11 Section 280 Improving Customer Experience Information Collection

ICR 202503-2900-010

OMB: 2900-0876

Federal Form Document

Forms and Documents

Document Name	Status
Form 2900-0876 ECCC – V ECCC – VA Loan Guaranty Form and Instruction	Unchanged
Form 2900-0876 ECCC – V ECCC – VA Loan Guaranty Form and Instruction	Unchanged
Form Telehealth Emergen Telehealth Emergency Medicine Survey Update Form and Instruction	Unchanged
Form Telehealth Emergen Telehealth Emergency Medicine Survey Update Form and Instruction	Unchanged
Form 2900-0876 Office of Community Care – IVC Survey Collection Form and Instruction	Unchanged
Form 2900-0876 Office of Community Care – IVC Survey Collection Form and Instruction	Unchanged
Form 2900-0876 ECCC – IVC VA Health Connect Form and Instruction	Unchanged
Form 2900-0876 ECCC – IVC VA Health Connect Form and Instruction	Unchanged
Form 2900-0876 VBA Education Survey Form and Instruction	Unchanged
Form 2900-0876 VBA Education Survey Form and Instruction	Unchanged
Form VFCE VEAC Email Su Veterans Family and Community Engagement (VFCE) Veterans Engagement Action Center (VEAC) Email & Exit Surveys Form and Instruction	Unchanged
Form VFCE VEAC Email Su Veterans Family and Community Engagement (VFCE) Veterans Engagement Action Center (VEAC) Email & Exit Surveys Form and Instruction	Unchanged
Form Annie Text Messagi Annie Text Messaging Survey Question Changes Form and Instruction	Unchanged
Form Annie Text Messagi Annie Text Messaging Survey Question Changes Form and Instruction	Unchanged
Form OSDBU CS Wireframe Office of Small & Disadvantaged Business Utilization (OSDBU) Customer Service & Lunch "N" Learn Survey Updates Form and Instruction	Unchanged
Form OSDBU CS Wireframe Office of Small & Disadvantaged Business Utilization (OSDBU) Customer Service & Lunch "N" Learn Survey Updates Form and Instruction	Unchanged
Form OSDBU IVR Wirefram Enterprise Contact Center Council (ECCC) Office of Small & Disadvantaged Business Utilization (OSDBU) Interactive Voice Response (IVR) Survey Form and Instruction	Unchanged
Form OSDBU IVR Wirefram Enterprise Contact Center Council (ECCC) Office of Small & Disadvantaged Business Utilization (OSDBU) Interactive Voice Response (IVR) Survey Form and Instruction	Unchanged
Form Personalized Caree Personalized Career Planning and Guidance (PGPC) Survey Form and Instruction	Unchanged
Form Personalized Caree Personalized Career Planning and Guidance (PGPC) Survey Form and Instruction	Unchanged
Form Wireframe Template Sturgis Rally VetFest 2024 Mini Registration Form and Instruction	Unchanged
Form Wireframe Template Sturgis Rally VetFest 2024 Mini Registration Form and Instruction	Unchanged
Form Healthy Teaching K Healthy Teaching Kitchen Survey Form and Instruction	Unchanged
Form Healthy Teaching K Healthy Teaching Kitchen Survey Form and Instruction	Unchanged
Form 2900-0876 After Vi After Visit Summary Survey Form and Instruction	Unchanged
Form 2900-0876 After Vi After Visit Summary Survey Form and Instruction	Unchanged
Form 2900-0876 MyHealth MyHealtheVet and Oracle Health Survey Form and Instruction	Unchanged
Form 2900-0876 MyHealth MyHealtheVet and Oracle Health Survey Form and Instruction	Unchanged
Form ECCC Member Servic Member Services Contact Center Survey Form and Instruction	Unchanged
Form ECCC Member Servic Member Services Contact Center Survey Form and Instruction	Unchanged
Form 2023-03-08 Compens VBA Compensation Survey - Increase Burden Form and Instruction	Unchanged
Form 2023-03-08 Compens VBA Compensation Survey - Increase Burden Form and Instruction	Unchanged
Form Survivor Survey survivor Survey Form and Instruction	Unchanged
Form Survivor Survey survivor Survey Form and Instruction	Unchanged
Form 2900-0876 Teleheal Telehealth Store and Forward Result Form and Instruction	Unchanged
Form 2900-0876 Teleheal Telehealth Store and Forward Result Form and Instruction	Unchanged
Form ECCC Vet Center Wi ECCC Vet Center Form and Instruction	Unchanged
Form ECCC Vet Center Wi ECCC Vet Center Form and Instruction	Unchanged
Form Participating VR&E VBA Veteran Readiness and Employment Survey Form and Instruction	Unchanged
Form Participating VR&E VBA Veteran Readiness and Employment Survey Form and Instruction	Unchanged
Form PCT survey Public Contact Team Survey Form and Instruction	Unchanged
Form PCT survey Public Contact Team Survey Form and Instruction	Unchanged
Form Indiana WF 1.12.24 Indiana Survey Form and Instruction	Unchanged
Form Indiana WF 1.12.24 Indiana Survey Form and Instruction	Unchanged
Form 2900-0876 Clinical Clinical Screening Tool Survey Form and Instruction	Unchanged
Form 2900-0876 Clinical Clinical Screening Tool Survey Form and Instruction	Unchanged
Form VIP Bootcamp Satis VIP Bootcamp Satisfaction Survey Form and Instruction	Unchanged
Form VIP Bootcamp Satis VIP Bootcamp Satisfaction Survey Form and Instruction	Unchanged
Form Compassionate Cont Compassionate Contact Corps Survey Form and Instruction	Unchanged
Form Compassionate Cont Compassionate Contact Corps Survey Form and Instruction	Unchanged
Form MOVE! Maintenance MOVE! Maintenance Pilot Program Survey Form and Instruction	Unchanged
Form MOVE! Maintenance MOVE! Maintenance Pilot Program Survey Form and Instruction	Unchanged
Form VSDHF Engagement S VSDHF Engagement Survey Form and Instruction	Unchanged
Form VSDHF Engagement S VSDHF Engagement Survey Form and Instruction	Unchanged
Form 2900-0876 Telemedi Telemedicine Form and Instruction	Unchanged
Form 2900-0876 Telemedi Telemedicine Form and Instruction	Unchanged
Form Anesthesia Patient Anesthesia Patient Satisfaction Survey Form and Instruction	Unchanged
Form Anesthesia Patient Anesthesia Patient Satisfaction Survey Form and Instruction	Unchanged
Form NFS Wireframe Nutrition & Food Service(NFS) Inpatient Survey Form and Instruction	Unchanged
Form NFS Wireframe Nutrition & Food Service(NFS) Inpatient Survey Form and Instruction	Unchanged
Form Homelessness WF 6. Homelessness Survey Form and Instruction	Unchanged
Form Homelessness WF 6. Homelessness Survey Form and Instruction	Unchanged
Form VRCN Wireframe 6.1 VetResources Community Network (VRCN) Survey Form and Instruction	Unchanged
Form VRCN Wireframe 6.1 VetResources Community Network (VRCN) Survey Form and Instruction	Unchanged
Form ECCC - VET HOME Su Enterprise Contact Center Council (ECCC) - Veterans Exposure Team-Health Outcomes Military Exposures (VET-HOME) Survey Form and Instruction	Unchanged
Form ECCC - VET HOME Su Enterprise Contact Center Council (ECCC) - Veterans Exposure Team-Health Outcomes Military Exposures (VET-HOME) Survey Form and Instruction	Unchanged
Form CLC WF with footer Community Living Center (CLC) Survey Form and Instruction	Unchanged
Form CLC WF with footer Community Living Center (CLC) Survey Form and Instruction	Unchanged
Form Northern Arizona D Northern Arizona Dental Service survey Form and Instruction	Unchanged
Form Northern Arizona D Northern Arizona Dental Service survey Form and Instruction	Unchanged
Form Under 40 Trust WF Under 40 Trust Project Form and Instruction	Unchanged
Form Under 40 Trust WF Under 40 Trust Project Form and Instruction	Unchanged
Form Solid Start Survey VA Solid Start Survey Form and Instruction	Unchanged
Form Solid Start Survey VA Solid Start Survey Form and Instruction	Unchanged
Form Promise to Address Promise to Address Comprehensive Toxics (PACT) Act Outreach survey Form and Instruction	Unchanged
Form Promise to Address Promise to Address Comprehensive Toxics (PACT) Act Outreach survey Form and Instruction	Unchanged
Form Compensation Surve VBA Compensation Survey Form and Instruction	Unchanged
Form Compensation Surve VBA Compensation Survey Form and Instruction	Unchanged
Form Military Exposures Military Exposure Survey Form and Instruction	Unchanged
Form Military Exposures Military Exposure Survey Form and Instruction	Unchanged
Form MOVE! Maintenance MOVE! Maintenance Pilot Program Form and Instruction	Unchanged
Form MOVE! Maintenance MOVE! Maintenance Pilot Program Form and Instruction	Unchanged
Form Long Covid Survey Long COVID Surveys Form and Instruction	Unchanged
Form Long Covid Survey Long COVID Surveys Form and Instruction	Unchanged
Form VA.gov VFS Questio VA.gov A-11 Surveys Form and Instruction	Unchanged
Form VA.gov VFS Questio VA.gov A-11 Surveys Form and Instruction	Unchanged
Form Annie Text Messagi Annie Text Messaging Survey Form and Instruction	Unchanged
Form Annie Text Messagi Annie Text Messaging Survey Form and Instruction	Unchanged
Form VRE CH31 - Learnin VBA Veterans Readiness and Employment (Chapter 31) Surveys Form and Instruction	Unchanged
Form VRE CH31 - Learnin VBA Veterans Readiness and Employment (Chapter 31) Surveys Form and Instruction	Unchanged
2900-0876 Non-Sub Change Request - EO 14168.docx Justification for No Material/Nonsubstantive Change	2025-03-21
2900-0876 Non-Sub Change Request - EO 14168.docx Justification for No Material/Nonsubstantive Change	2025-03-14
30-day FRN 2900-0876.pdf Supplementary Document	2022-12-30
30-day FRN 2900-0876.pdf Supplementary Document	2022-12-30
60 Day FRN.pdf Supplementary Document	2022-12-21
60 Day FRN.pdf Supplementary Document	2022-12-21
A-11 30-day FRN_ 2900-0876 17Oct2022.docx Supplementary Document	2022-10-17
A-11 30-day FRN_ 2900-0876 17Oct2022.docx Supplementary Document	2022-10-17
A-11 60-day FRN_ 2900-0876 17Oct2022.docx Supplementary Document	2022-10-17
A-11 60-day FRN_ 2900-0876 17Oct2022.docx Supplementary Document	2022-10-17
2900-0876 SSA (Final 2022-02-01).docx Supporting Statement A	2023-02-01
2900-0876 SSA (Final 2022-02-01).docx Supporting Statement A	2023-02-01
A-11 Fast-Track Clearance Request Template.docx Supplementary Document	2020-03-13
A-11 Fast-Track Clearance Request Template.docx Supplementary Document	2020-03-13
Supporting Statement B for Agencies_A 11 Section 280 Improving Customer Experience.docx Supporting Statement B	2022-10-13
Supporting Statement B for Agencies_A 11 Section 280 Improving Customer Experience.docx Supporting Statement B	2022-10-13

IC Document Collections

IC ID	Document Title	Status
274354	ECCC – VA Loan Guaranty Form and Instruction	Unchanged
274354	ECCC – VA Loan Guaranty Form and Instruction	Unchanged
274197	Telehealth Emergency Medicine Survey Update Form and Instruction	Unchanged
274197	Telehealth Emergency Medicine Survey Update Form and Instruction	Unchanged
274194	Veteran Transportation Surveys Other-Survey Instrument	Unchanged
273946	Office of Community Care – IVC Survey Collection Form and Instruction	Unchanged
273946	Office of Community Care – IVC Survey Collection Form and Instruction	Unchanged
273856	ECCC – IVC VA Health Connect Form and Instruction	Unchanged
273856	ECCC – IVC VA Health Connect Form and Instruction	Unchanged
273754	VBA Education Survey Form and Instruction	Unchanged
273754	VBA Education Survey Form and Instruction	Unchanged
273477	VA OIG Viewer Interest Project Other-Survey Instrument	Unchanged
272998	Veterans Family and Community Engagement (VFCE) Veterans Engagement Action Center (VEAC) Email & Exit Surveys Form and Instruction	Unchanged
272998	Veterans Family and Community Engagement (VFCE) Veterans Engagement Action Center (VEAC) Email & Exit Surveys Form and Instruction	Unchanged
272962	Annie Text Messaging Survey Question Changes Form and Instruction	Unchanged
272962	Annie Text Messaging Survey Question Changes Form and Instruction	Unchanged
272799	Office of Small & Disadvantaged Business Utilization (OSDBU) Customer Service & Lunch "N" Learn Survey Updates Form and Instruction	Unchanged
272799	Office of Small & Disadvantaged Business Utilization (OSDBU) Customer Service & Lunch "N" Learn Survey Updates Form and Instruction	Unchanged
272611	VHA Community Living Center - Add SCI/D question Other-Survey Instrument	Unchanged
272507	VHA ALS Customer Experience Survey Other-Survey Instrument	Unchanged
272500	Beneficiary Travel Self Service System (BTSSS) Survey Question updates Other-Survey Instrument	Unchanged
272432	Enterprise Contact Center Council (ECCC) Office of Small & Disadvantaged Business Utilization (OSDBU) Interactive Voice Response (IVR) Survey Form and Instruction	Unchanged
272432	Enterprise Contact Center Council (ECCC) Office of Small & Disadvantaged Business Utilization (OSDBU) Interactive Voice Response (IVR) Survey Form and Instruction	Unchanged
272393	Personalized Career Planning and Guidance (PGPC) Survey Form and Instruction	Unchanged
272393	Personalized Career Planning and Guidance (PGPC) Survey Form and Instruction	Unchanged
269874	Annie Text Messaging Survey Question Changes Other-Survey Instrument	Unchanged
269793	Sturgis Rally VetFest 2024 Mini Registration Form and Instruction	Unchanged
269793	Sturgis Rally VetFest 2024 Mini Registration Form and Instruction	Unchanged
269523	Healthy Teaching Kitchen Survey Form and Instruction	Unchanged
269523	Healthy Teaching Kitchen Survey Form and Instruction	Unchanged
269404	After Visit Summary Survey Form and Instruction	Unchanged
269404	After Visit Summary Survey Form and Instruction	Unchanged
269189	MyHealtheVet and Oracle Health Survey Form and Instruction	Unchanged
269189	MyHealtheVet and Oracle Health Survey Form and Instruction	Unchanged
269049	Member Services Contact Center Survey Form and Instruction	Unchanged
269049	Member Services Contact Center Survey Form and Instruction	Unchanged
268403	VBA Compensation Survey - Increase Burden Form and Instruction	Unchanged
268403	VBA Compensation Survey - Increase Burden Form and Instruction	Unchanged
268074	Blind and Low Vision Rehabilitation Survey Other-Survey Instrument	Unchanged
267667	survivor Survey Form and Instruction	Unchanged
267667	survivor Survey Form and Instruction	Unchanged
267302	Nutrition and Food Service Inpatient Survey - Updated Question Other-Survey Instrument	Unchanged
266993	VEAC/Outreach Naming Survey Other-Survey Instrument	Unchanged
266324	Telehealth Store and Forward Result Form and Instruction	Unchanged
266324	Telehealth Store and Forward Result Form and Instruction	Unchanged
266009	ECCC Vet Center Form and Instruction	Unchanged
266009	ECCC Vet Center Form and Instruction	Unchanged
265731	VBA Veteran Readiness and Employment Survey Form and Instruction	Unchanged
265731	VBA Veteran Readiness and Employment Survey Form and Instruction	Unchanged
265530	VFCE VEAC Survey - Updated Trust Question Other-Survey Instrument	Unchanged
265526	Community Living Centers (CLC) Survey-Updated trust question Other-Survey Instrument	Unchanged
265229	Public Contact Team Survey Form and Instruction	Unchanged
265229	Public Contact Team Survey Form and Instruction	Unchanged
264539	Indiana Survey Form and Instruction	Unchanged
264539	Indiana Survey Form and Instruction	Unchanged
264139	Spanish Benefits Letter Survey Other-Survey Instrument	Unchanged
262871	Clinical Screening Tool Survey Form and Instruction	Unchanged
262871	Clinical Screening Tool Survey Form and Instruction	Unchanged
262578	VIP Bootcamp Satisfaction Survey Form and Instruction	Unchanged
262578	VIP Bootcamp Satisfaction Survey Form and Instruction	Unchanged
262424	Compassionate Contact Corps Survey Form and Instruction	Unchanged
262424	Compassionate Contact Corps Survey Form and Instruction	Unchanged
262422	Support Staff Post Veterans Experience Action Center (VEAC) Other-Survey Instrument	Unchanged
262120	Ensuring Awareness of Benefits and Services of NCA Other-Survey Instrument	Unchanged
261945	Beneficiary Travel Self Service System (BTSSS) Survey Other-Survey Instrument	Unchanged
261942	MOVE! Maintenance Pilot Program Survey Form and Instruction	Unchanged
261942	MOVE! Maintenance Pilot Program Survey Form and Instruction	Unchanged
261804	Outpatient-Labs and Imaging - Add Mammography Questions Other-Survey Instrument	Unchanged
261791	VSDHF Engagement Survey Form and Instruction	Unchanged
261791	VSDHF Engagement Survey Form and Instruction	Unchanged
261780	Telemedicine Form and Instruction	Unchanged
261780	Telemedicine Form and Instruction	Unchanged
261480	Anesthesia Patient Satisfaction Survey Form and Instruction	Unchanged
261480	Anesthesia Patient Satisfaction Survey Form and Instruction	Unchanged
261190	Clinical Contact Center Survey-Update Burden Other-Survey Instrument	Unchanged
260965	Nutrition & Food Service(NFS) Inpatient Survey Form and Instruction	Unchanged
260965	Nutrition & Food Service(NFS) Inpatient Survey Form and Instruction	Unchanged
260783	Homelessness Survey Form and Instruction	Unchanged
260783	Homelessness Survey Form and Instruction	Unchanged
260683	VetResources Community Network (VRCN) Survey Form and Instruction	Unchanged
260683	VetResources Community Network (VRCN) Survey Form and Instruction	Unchanged
260557	Enterprise Contact Center Council (ECCC) - Veterans Exposure Team-Health Outcomes Military Exposures (VET-HOME) Survey Form and Instruction	Unchanged
260557	Enterprise Contact Center Council (ECCC) - Veterans Exposure Team-Health Outcomes Military Exposures (VET-HOME) Survey Form and Instruction	Unchanged
260348	Community Living Center (CLC) Survey Form and Instruction	Unchanged
260348	Community Living Center (CLC) Survey Form and Instruction	Unchanged
260108	Northern Arizona Dental Service survey Form and Instruction	Unchanged
260108	Northern Arizona Dental Service survey Form and Instruction	Unchanged
259926	Under 40 Trust Project Form and Instruction	Unchanged
259926	Under 40 Trust Project Form and Instruction	Unchanged
259840	VA Solid Start Survey Form and Instruction	Unchanged
259840	VA Solid Start Survey Form and Instruction	Unchanged
259612	Promise to Address Comprehensive Toxics (PACT) Act Outreach survey Form and Instruction	Unchanged
259612	Promise to Address Comprehensive Toxics (PACT) Act Outreach survey Form and Instruction	Unchanged
259047	VBA Compensation Survey Form and Instruction	Unchanged
259047	VBA Compensation Survey Form and Instruction	Unchanged
259032	Military Exposure Survey Form and Instruction	Unchanged
259032	Military Exposure Survey Form and Instruction	Unchanged
258896	MOVE! Maintenance Pilot Program Form and Instruction	Unchanged
258896	MOVE! Maintenance Pilot Program Form and Instruction	Unchanged
258567	Long COVID Surveys Form and Instruction	Unchanged
258567	Long COVID Surveys Form and Instruction	Unchanged
258501	VA.gov A-11 Surveys Form and Instruction	Unchanged
258501	VA.gov A-11 Surveys Form and Instruction	Unchanged
258478	Annie Text Messaging Survey Form and Instruction	Unchanged
258478	Annie Text Messaging Survey Form and Instruction	Unchanged
258284	VBA Veterans Readiness and Employment (Chapter 31) Surveys Form and Instruction	Unchanged
258284	VBA Veterans Readiness and Employment (Chapter 31) Surveys Form and Instruction	Unchanged

ICR Details