Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
A-11 Fast-Track Clearance Request Template_MOVE! Weight Management Program New 4000 333 0 Form and Instruction MOVE! Weight Management Program Survey Wireframe MOVE! Weight Management Program Survey Wireframe
BTSS Survey New 1000 83 0 Form and Instruction BTSSS Survey WF BTSSS Survey WF
CHAMPVA Program Survey New 3420 285 0 Form and Instruction OCC CHAMPVA OCC CHAMPVA
CSP Surveys New 19915 1377 0 Form and Instruction CSP New Enrollee Survey V1.3 WF CSP New Enrollee Survey V1.3 WF
Form and Instruction CPS Program Survey V1.3 WF CPS Program Survey V1.3 WF
Form and Instruction CSP Staff Survey V1.4 WF CSP Staff Survey V1.4 WF
Childcare Provisions Survey New 30000 1000 0 Form and Instruction Childcare Provisions Survey Childcare Provisions Survey
Community Care Satisfaction Survey New 300 15 0 Form and Instruction Community Care Satisfaction Survey Wireframe Community Care Satisfaction Survey Wireframe
Community Care Social Survey New 1000 83 0 Form and Instruction Community Care Social Survey WF Community Care Social Survey WF
Enterprise Contact Center Council (ECCC) Caregivers New 9763 163 0 Form and Instruction ECCC Caregivers WF V4 2021-10-21 ECCC Caregivers WF V4 2021-10-21
Enterprise Contact Center Council (ECCC) Coaching Into Care (CIC) New 550 18 0 Form and Instruction ECCC Coaching into Care Survey Wireframe V10 Fina ECCC Coaching into Care Survey Wireframe V10 Final 2022-02-04
Enterprise Contact Center Council (ECCC) Office of Small & Disadvantaged Business Utilization's (OSDBU) New 1266 42 0 Form and Instruction ECCC-OSDBU Wireframe ECCC-OSDBU Wireframe
Enterprise Contact Center Council (ECCC) Women Veterans New 39000 1300 0 Form and Instruction ECCC WVCC Survey Wireframe OMB Submission 21-12-06 ECCC WVCC Survey Wireframe OMB Submission 21-12-06
Geriatrics Extended Care (GEC) Home Based Care Survey New 16021 534 0 Form and Instruction GEC Home Based Care Survey GEC Home Based Care Survey
LGY - SAH New 792 53 0 Form and Instruction LGY SURVEY1 LGY SURVEY1
Form and Instruction LGY SURVEY2 LGY SURVEY2
Form and Instruction LGY SURVEY3 LGY SURVEY3
Lexington VAMC Commit-to-Sit Survey New 1200 100 0 Form and Instruction Lexington VAMC Commit-to-Sit Survey WF Lexington VAMC Commit-to-Sit Survey WF
Military-to-Civilian Transition Project New 75 75 0 Form and Instruction Transition Discovery_Research Plan Transition Discovery_Research Plan
Form and Instruction Transition_Discovery Research_Recruiting Script Transition_Discovery Research_Recruiting Script
Form and Instruction HCD_consent_VA HCD_consent_VA
Military-to-Civilian Transition Survey New 2000 100 0 Form and Instruction Mil-to-Civ Transition_Survey WF Mil-to-Civ Transition_Survey WF
NCA Visitor Experience Survey New 100000 8333 0 Form and Instruction NCA Visitor Experience Survey Wireframes NCA Visitor Experience Survey Wireframes
No Show Mental Health Survey New 58200 2910 0 Form and Instruction No-Show - Established Patient Survey Wireframe No-Show - Established Patient Survey Wireframe
Form and Instruction No-Show - New Patient Survey Wireframe No-Show - New Patient Survey Wireframe
North Carolina VEAC Event Survey V2 New 1000 83 0 Form and Instruction NC Outreach Event Survey Questions v5 NC Outreach Event Survey Questions v5
OPIA/VEO COVID Booster Customer Survey New 30000 1000 0 Form and Instruction COVID Booster COVID Booster
OSDBU Survey New 5000 250 0 Form and Instruction OSDBU Survey Wireframes V9 Final OMB Submission OSDBU Survey Wireframes V9 Final OMB Submission
Office of Connected Care-Annie New 10000 833 0 Form and Instruction Office of Connected Care - Annie Survey Wireframe Office of Connected Care - Annie Survey Wireframe
Outpatient SCI Survey New 50 4 0 Form and Instruction OutPatient SCI WF 1 OutPatient SCI WF 1
Form and Instruction OutPatient SCI WF 2 OutPatient SCI WF 2
PACT Act Claim survey New 200000 10000 0 Other-Survey
Telehealth ATLAS VSignals Survey New 200 17 0 Form and Instruction 2900-0876-ATLAS Survey Wireframes 2900-0876-ATLAS Survey Wireframes
Telemedicine Survey New 604800 30240 0 Form and Instruction Telemedicine: Telehealth Appointment Scheduling Telemedicine: Telehealth Appointment Scheduling
Uber Transportation Pilot Survey New 18000 600 0 Form and Instruction VHUC Survey V1.1 Wireframe VHUC Survey V1.1 Wireframe
VA Mission Refresh Survey New 3000 150 0 Form and Instruction 2900-0876-VA Mission Statement Survey 2900-0876-VA Mission Statement Survey
VA Mission Statement Survey New 50000 833 0 Form and Instruction VA Mission Statement Survey VA Mission Statement Survey
VA Mission Statement Survey New 50000 4167 0 Form and Instruction 2022-09-30 VA Mission Statement Survey.pdf 2022-09-30 VA Mission Statement Survey.pdf
VA Office of the Inspector General Website User Feedback Survey New 10000 333 0 Form 2900-0876 VA OIG Website User Feedback Survey Instrument
VA Voter Registration Survey New 50000 4167 0 Form and Instruction VA Voter Registration Survey VA Voter Registration
VA-Wide Trust Survey New 200000 16667 0 Form and Instruction VA Wide Trust Survey Wireframe VA Wide Trust Survey Wireframe
Form and Instruction VA Wide Trust Survey Sampling Plan VA Wide Trust Survey Sampling Plan
VBA Education Service Survey New 57984 4832 0 Form and Instruction VBA Education Service - Applying for Benefits VBA Education Service - Applying for Benefits
Form and Instruction VBA Education Service - Receiving the Application VBA Education Service - Receiving the Application Decision
Form and Instruction VBA Education Service - Enrolling in School VBA Education Service - Enrolling in School
Form and Instruction VBA Education Service - Receiving Education Benef VBA Education Service - Receiving Education Benefits
VBA Insurance End Products Survey New 6540 436 0 Form and Instruction Beneficiary_Designation Beneficiary_Designation
Form and Instruction Cash_Surrender_Policy_Loan Cash_Surrender_Policy_Loan
Form and Instruction Correspondence Correspondence
Form and Instruction Death Claims Death Claims
Form and Instruction New Insurance New Insurance
Form and Instruction VMLI VMLI
VBA Outreach, Transition, and Economic Development (OTED) Survey New 7000 583 0 Form and Instruction OTED Survey Wireframes OTED Survey Wireframes
VBA Veteran Rapid Retraining Assistance Program Experience Survey New 504 17 0 Form and Instruction 30 Day Experience 30 Day Experience
Form and Instruction 60 Day Experience 60 Day Experience
Form and Instruction 90 Day Experience 90 Day Experience
Form and Instruction 180 Day Experience 180 Day Experience
Form and Instruction Experience After Meaningful Employment Experience After Meaningful Employment
VBA Veteran Readiness and Employment (Chapter 31) Survey New 11448 954 0 Form and Instruction VRE CH31 - Learning About and Applying for VRE VRE CH31 - Learning About and Applying for VRE
Form and Instruction VRE CH31 - Participating in VRE VRE CH31 - Participating in VRE
Form and Instruction VRE CH31 - Completing VRE VRE CH31 - Completing VRE
VSO Liaison Survey New 1000 83 0 Form and Instruction VSO Liaison Survey WF VSO Liaison Survey WF
VetResources Survey New 50000 1667 0 Form and Instruction VetResources Survey Questions VetResources Survey Questions
VetXL CSignals Needs Survey New 1000 83 0 Form and Instruction VetXL CSignals Needs Survey VetXL CSignals Needs Survey
Veterans Engagement Action Center (VEAC) Surveys New 12000 1000 0 Form and Instruction VFCE VEAC Surveys VFCE VEAC Surveys
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 1668028 95803 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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