View Information Collection (IC)

View Information Collection (IC)

DBQs
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form VA Form 21-0960A-2 Artery and Vein Conditions (Vascular Diseases Including Varicose Veins) DBQ 21-0960A-2.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960A-3 Hypertension DBQ 21-0960A-3.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960A-4 Non-Ischemic Heart Disease (Including Arrhythmias and Surgery) DBQ 21-0960A-4.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960C-4 Diabetic Peripheral Neuropathy (Diabetic Sensory-Motor Peripheral Neuropathy) DBQ 21-0960C-4.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960E-1 Diabetes Mellitus DBQ 21-0960E-1.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960F-1 Scars/Disfigurement DBQ 21-0960F-1.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960F-2 Skin Diseases DBQ 21-0960F-2.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-1 Amputations DBQ 21-0960M-1.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-2 Ankle Conditions DBQ 21-0960M-2.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-4 Elbow and Forearm Conditions DBQ 21-0960M-4.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-5 Flatfoot (Pes Planus) DBQ 21-0960M-5.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-6 Foot Miscellaneous (Other than Flatfoot/Pes Planus) DBQ 21-0960M-6.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-7 Hand and Finger Conditions DBQ 21-0960M-7.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-8 Hip and Thigh Conditions DBQ 21-0960M-8.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-9 Knee and Lower Leg Conditions DBQ 21-0960M-9.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-10 Muscle Injuries DBQ 21-0960M-10.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-12 Shoulder and Arm Conditions DBQ 21-0960M-12.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-15 Temporomandibular Joint Conditions DBQ 21-0960M-15.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-16 Wrist Conditions DBQ 21-0960M-16.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960N-2 Eye Conditions DBQ 21-0960N-2.pdf www.va.gov/vaforms Yes No Fillable Printable

General Government Legislative Functions

 

725,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 725,000 0 725,000 0 0 0
Annual IC Time Burden (Hours) 311,250 0 311,250 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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