Title:CEPACT (Center for Evaluation of PACT) Demographic Questionnaire, VA Form 10-0534 and Patient Focus Group.
OMB Control Number:2900-New (VA Form 10-0534).
Type of Review:New data collection.
Abstract:The data collected on VA Form 10-0534 will be used to implement the PACT model that will in turn improve health care for Veterans and sustain VA's leadership in health care quality. This will be done to evaluate the effectiveness of various types of care delivered to patients throughout the PACT model.
Affected Public:Individuals or households.
Estimated Annual Burden:226.
Estimated Average Burden per Respondent:85 minutes for focus group; 5 minutes for questionnaire.
Frequency of Response:One-time.
Estimated Number of Respondents:150.
Estimated Number of Responses:300.
Dated: August 16, 2012.
By direction of the Secretary.
Program Analyst Director, Enterprise Records Service.