View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 2900-0712	ICR Reference No: 201001-2900-008
Status: Historical Active	Previous ICR Reference No: 200710-2900-003
Agency/Subagency: VA	Agency Tracking No: 2900-0712
Title: Nation-wide Customer Satisfaction Surveys
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/21/2011
	Date Received in OIRA: 06/10/2010
Terms of Clearance: Approved consistent with revisions submitted by the VA and included in the public docket.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2014	36 Months From Approved	03/31/2011
Responses	301,244	0	301,244
Time Burden (Hours)	96,125	0	96,750
Cost Burden (Dollars)	0	0	0

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Nation-wide Customer Satisfaction Surveys	VA Form 10-1465-4, VA Form 10-1465-3, VA Form 10-1465-2	, ,

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	301,244	301,244	0
Annual Time Burden (Hours)	96,125	96,750	-625
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Long form 10-1464-1 has been discontinued. VHA identified alternative sources for the information collected from the additional questions on the survey and no longer needs to collect the information via the Inpatient satisfaction survey. Therefore, all patients selected for this survey project will now receive VA Form 10-1465-2, Inpatient short form.

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