b. General Adherence Scale, VA Form 10-0530a.
c. Demographic Data: Patient Background Information, VA Form 10-0530b.
OMB Control Number:2900-New.
Type of Review:New data collection.
Abstract:This patient self-assessment of health study and patient satisfaction questionnaire seek to collect individual, primary data from patients concerning attitudes toward healthcare. The VHA PACT Demo Lab is a new grant-funded project. No existing information can beused to adequately evaluate the VHA PACT, evaluate patient experiences with PACT over time, and inform improvements to the redesign and its newly implemented innovations.
Affected Public:Individuals or households.
Estimated Annual Burden:
a. VA Form 10-0530—25 hours.
b. VA Form 10-0530a—17 hours.
c. VA Form 10-0530b—17 hours.
Estimated Average Burden Per Respondent:
a. VA Form 10-0530—3 minutes.
b. VA Form 10-0530a—2 minutes.
c. VA Form 10-0530b—2 minutes.
Frequency of Response:One-time.
Estimated Number of Respondents:
a. VA Form 10-0530—500.
b. VA Form 10-0530a—500.
c. VA Form 10-0530b—500.
Dated: August 16, 2012.
By direction of the Secretary.
Program Analyst Director, Enterprise Records Service.