Proposed Information Collection (Request for and Authorization To Release Medical Records or Health Information) Activity: Comment Request, 46484-46485 [E9-21574]
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Federal Register / Vol. 74, No. 173 / Wednesday, September 9, 2009 / Notices
Affected Public: Individuals or
households.
Estimated Annual Burden:
a. Annual-Final Report and Account,
VA Form 21–4706—1,100.
b. Federal Fiduciary’s Account, VA
Form 21–4706b—6,300.
c. Court Appointed Fiduciary’s
Account, VA Form 21–4706c—2,000.
d. Account Book, VA Form 21–4718—
20,000.
e. Certificate of Balance on Deposit
and Authorization To Disclose Financial
Records, VA Form 21–4718a–166.
Estimated Average Burden per
Respondent:
a. Annual-Final Report and Account,
VA Form 21–4706—30 minutes.
b. Federal Fiduciary’s Accounts, VA
Form 21–4706b—27 minutes.
c. Court Appointed Fiduciary’s
Account, VA Form 21–4706c—30
minutes.
d. Account Book, VA Form 21–4718–
21⁄2 hours.
e. Certificate of Balance on Deposit
and Authorization To Disclose Financial
Records, VA Form 21–4718a–3 minutes.
Frequency of Response: Annually.
Estimated Number of Respondents:
a. Annual-Final Report and Account,
VA Form 21–4706–2,200.
b. Federal Fiduciary’s Accounts, VA
Form 21–4706b–14,000.
c. Court Appointed Fiduciary’s
Account, VA Form 21–4706c–4,000.
d. Account Book, VA Form 21–4718–
8,000.
e. Certificate of Balance on Deposit
and Authorization To Disclose Financial
Records, VA Form 21–4718a–3,312.
Dated: September 2, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9–21572 Filed 9–8–09; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0427]
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Agency Information Collection (Former
POW Medical History), VA Form 10–
0048 Activities Under OMB Review
AGENCY: Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
In compliance with the
Paperwork Reduction Act (PRA) of 1995
(44 U.S.C. 3501–3521), this notice
announces that the Veterans Health
Administration (VHA), Department of
Veterans Affairs, will submit the
SUMMARY:
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15:47 Sep 08, 2009
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collection of information abstracted
below to the Office of Management and
Budget (OMB) for review and comment.
The PRA submission describes the
nature of the information collection and
its expected cost and burden and
includes the actual data collection
instrument.
DATES: Comments must be submitted on
or before October 9, 2009.
Submit written comments
on the collection of information through
https://www.Regulations.gov; or to VA’s
OMB Desk Officer, OMB Human
Resources and Housing Branch, New
Executive Office Building, Room 10235,
Washington, DC 20503 (202) 395–7316.
Please refer to ‘‘OMB Control No. 2900–
0427’’ in any correspondence.
ADDRESSES:
FOR FURTHER INFORMATION CONTACT:
Denise McLamb, Enterprise Records
Service (005R1B), Department of
Veterans Affairs, 810 Vermont Avenue,
NW., Washington, DC 20420, (202) 461–
7485, fax (202) 273–0443 or e-mail
denise.mclamb@mail.va.gov. Please
refer to ‘‘OMB Control No. 2900–0427.’’
SUPPLEMENTARY INFORMATION:
Titles: Former POW Medical History,
VA Form 10–0048.
OMB Control Number: 2900–0427.
Type of Review: Revision of a
currently approved collection.
Abstract: VA Form 10–0048 is
completed by a VA physician during a
medical examination of a Former
Prisoner of War veteran. VA will use the
data collected as a guide and reference
for treatment planning for the FPOW
veteran.
An agency may not conduct or
sponsor, and a person is not required to
respond to a collection of information
unless it displays a currently valid OMB
control number. The Federal Register
Notice with a 60-day comment period
soliciting comments on this collection
of information was published on June
29, 2009, at pages 31110–31111.
Affected Public: Individuals or
households.
Estimated Total Annual Burden: 113
hours.
Estimated Average Burden per
Respondent: 90 minutes.
Frequency of Response: One time.
Estimated Number of Respondents:
75.
Dated: September 2, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9–21573 Filed 9–8–09; 8:45 am]
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DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0260]
Proposed Information Collection
(Request for and Authorization To
Release Medical Records or Health
Information) Activity: Comment
Request
AGENCY: Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
SUMMARY: The Veterans Health
Administration (VHA) is announcing an
opportunity for public comment on the
proposed collection of certain
information by the agency. Under the
Paperwork Reduction Act (PRA) of
1995, Federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information, including each proposed
revision of a currently approved
collection, and allow 60 days for public
comment in response to the notice. This
notice solicits comments on information
needed to obtain a patient written
consent to disclose medical records or
health information to individuals or
third parties.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before November 9, 2009.
ADDRESSES: Submit written comments
on the collection of information through
Federal Docket Management System
(FDMS) at www.Regulations.gov; or to
Mary Stout, Veterans Health
Administration (193E1), Department of
Veterans Affairs, 810 Vermont Avenue,
NW., Washington, DC 20420 or e-mail:
mary.stout@va.gov. Please refer to
‘‘OMB Control No. 2900–0260’’ in any
correspondence. During the comment
period, comments may be viewed online
through FDMS.
FOR FURTHER INFORMATION CONTACT:
Mary Stout, (202) 461–5867 or FAX
(202) 273–9381.
SUPPLEMENTARY INFORMATION: Under the
PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
3501–3521), Federal agencies must
obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. This request for comment is
being made pursuant to Section
3506(c)(2)(A) of the PRA.
With respect to the following
collection of information, VHA invites
comments on: (1) Whether the proposed
collection of information is necessary
for the proper performance of VHA’s
functions, including whether the
E:\FR\FM\09SEN1.SGM
09SEN1
cprice-sewell on DSK2BSOYB1PROD with NOTICES
Federal Register / Vol. 74, No. 173 / Wednesday, September 9, 2009 / Notices
information will have practical utility;
(2) the accuracy of VHA’s estimate of
the burden of the proposed collection of
information; (3) ways to enhance the
quality, utility, and clarity of the
information to be collected; and (4)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques or
the use of other forms of information
technology.
Titles:
a. Request for and Authorization To
Release Medical Records or Health
Information, VA Form 10–5345.
b. Individual’s Request for a Copy of
Their Own Health Information, VA
Form 10–5345a.
c. My HealtheVet (MHV)—
Individuals’ Request for a Copy of Their
Own Health Information, VA Form 10–
5345a–MHV.
OMB Control Number: 2900–0260.
Type of Review: Revision of a
currently approved collection.
Abstract:
a. VA Form 10–5345 is used to obtain
a written consent from patients before
information concerning his or her
treatment for alcoholism or alcohol
abuse, drug abuse, sickle cell anemia, or
infection with the human
immunodeficiency virus (HIV) can be
disclosed to private insurance
companies, physicians and other third
parties.
b. Patients complete VA Form 10–
5345a to request a copy of their health
information maintained at Department
of Veterans Affairs.
c. VA Form 10–5345a–MHV is
completed by individuals requesting
their health information electronically
through My HealtheVet.
Affected Public: Individuals or
households.
Estimated Total Annual Burden:
a. VA Form 10–5345—15,000 hours.
b. VA Form 10–5345a—15,000 hours.
c. VA Form 10–5345a–MVH—35,000
hours.
Estimated Average Burden per
Respondent:
a. VA Form 10–5345—3 minutes.
b. VA Form 10–5345a—3 minutes.
c. VA Form 10–5345a–MVH—3
minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
a. VA Form 10–5345—300,000.
b. VA Form 10–5345a—300,000.
c. 10–5345a–MVH—700,000.
Dated: September 2, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9–21574 Filed 9–8–09; 8:45 am]
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DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–New (10–0468)]
Proposed Information Collection
(Internet Student CPR Web
Registration Application); Comment
Request
AGENCY: Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
SUMMARY: The Veterans Health
Administration (VHA), Department of
Veterans Affairs, is announcing an
opportunity for public comment on the
proposed collection of certain
information by the agency. Under the
Paperwork Reduction Act (PRA) of
1995, Federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information, including each proposed
new collection, and allow 60 days for
public comment in response to the
notice. This notice solicits comments on
information needed to establish an
online Web registration application.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before November 9, 2009.
ADDRESSES: Submit written comments
on the collection of information through
the Federal Docket Management System
(FDMS) at https://www.Regulations.gov;
or to Mary Stout, Veterans Health
Administration (193E1), Department of
Veterans Affairs, 810 Vermont Avenue,
NW., Washington, DC 20420 or e-mail:
mary.stout@va.gov. Please refer to
‘‘OMB Control No. 2900–New (10–
0468)’’ in any correspondence. During
the comment period, comments may be
viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT:
Mary Stout at (202) 461–5867 or FAX
(202) 273–9381.
SUPPLEMENTARY INFORMATION: Under the
PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
3501–3521), Federal agencies must
obtain approval from OMB for each
collection of information they conduct
or sponsor. This request for comment is
being made pursuant to Section
3506(c)(2)(A) of the PRA.
With respect to the following
collection of information, VHA invites
comments on: (1) Whether the proposed
collection of information is necessary
for the proper performance of VHA’s
functions, including whether the
information will have practical utility;
(2) the accuracy of VHA’s estimate of
the burden of the proposed collection of
information; (3) ways to enhance the
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46485
quality, utility, and clarity of the
information to be collected; and (4)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques or
the use of other forms of information
technology.
Title: Internet Student CPR Web
Registration Application, VA Form 10–
0468.
OMB Control Number: 2900–New
(10–0468).
Type of Review: New collection.
Abstract: The data collected on VA
Form 10–0468 will be used to establish
a roster on students attending courses
provided by the Minneapolis VA
Medical Center Education Service.
Students will be able to identify and
register for a training course online
without waiting for the Registrar to
return calls or e-mails to confirm
enrollment.
Affected Public: Individuals or
households.
Estimated Annual Burden: 125 hours.
Estimated Average Burden per
Respondent: 5 minutes.
Frequency of Response: Bi-Annually.
Estimated Number of Responses:
1,500.
Dated: September 2, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9–21576 Filed 9–8–09; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–New (10–0473)]
Proposed Information Collection
(Millennium Bill Emergency Care
Provider Satisfaction Survey);
Comment Request
AGENCY: Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
SUMMARY: The Veterans Health
Administration (VHA), Department of
Veterans Affairs (VA), is announcing an
opportunity for public comment on the
proposed collection of certain
information by the agency. Under the
Paperwork Reduction Act (PRA) of
1995, Federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information, including each proposed
new collection, and allow 60 days for
public comment in response to the
notice. This notice solicits comments on
E:\FR\FM\09SEN1.SGM
09SEN1
Agencies
[Federal Register Volume 74, Number 173 (Wednesday, September 9, 2009)]
[Notices]
[Pages 46484-46485]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-21574]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0260]
Proposed Information Collection (Request for and Authorization To
Release Medical Records or Health Information) Activity: Comment
Request
AGENCY: Veterans Health Administration, Department of Veterans Affairs.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Veterans Health Administration (VHA) is announcing an
opportunity for public comment on the proposed collection of certain
information by the agency. Under the Paperwork Reduction Act (PRA) of
1995, Federal agencies are required to publish notice in the Federal
Register concerning each proposed collection of information, including
each proposed revision of a currently approved collection, and allow 60
days for public comment in response to the notice. This notice solicits
comments on information needed to obtain a patient written consent to
disclose medical records or health information to individuals or third
parties.
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before November 9, 2009.
ADDRESSES: Submit written comments on the collection of information
through Federal Docket Management System (FDMS) at www.Regulations.gov;
or to Mary Stout, Veterans Health Administration (193E1), Department of
Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420 or e-
mail: mary.stout@va.gov. Please refer to ``OMB Control No. 2900-0260''
in any correspondence. During the comment period, comments may be
viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT: Mary Stout, (202) 461-5867 or FAX
(202) 273-9381.
SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44
U.S.C. 3501-3521), Federal agencies must obtain approval from the
Office of Management and Budget (OMB) for each collection of
information they conduct or sponsor. This request for comment is being
made pursuant to Section 3506(c)(2)(A) of the PRA.
With respect to the following collection of information, VHA
invites comments on: (1) Whether the proposed collection of information
is necessary for the proper performance of VHA's functions, including
whether the
[[Page 46485]]
information will have practical utility; (2) the accuracy of VHA's
estimate of the burden of the proposed collection of information; (3)
ways to enhance the quality, utility, and clarity of the information to
be collected; and (4) ways to minimize the burden of the collection of
information on respondents, including through the use of automated
collection techniques or the use of other forms of information
technology.
Titles:
a. Request for and Authorization To Release Medical Records or
Health Information, VA Form 10-5345.
b. Individual's Request for a Copy of Their Own Health Information,
VA Form 10-5345a.
c. My HealtheVet (MHV)--Individuals' Request for a Copy of Their
Own Health Information, VA Form 10-5345a-MHV.
OMB Control Number: 2900-0260.
Type of Review: Revision of a currently approved collection.
Abstract:
a. VA Form 10-5345 is used to obtain a written consent from
patients before information concerning his or her treatment for
alcoholism or alcohol abuse, drug abuse, sickle cell anemia, or
infection with the human immunodeficiency virus (HIV) can be disclosed
to private insurance companies, physicians and other third parties.
b. Patients complete VA Form 10-5345a to request a copy of their
health information maintained at Department of Veterans Affairs.
c. VA Form 10-5345a-MHV is completed by individuals requesting
their health information electronically through My HealtheVet.
Affected Public: Individuals or households.
Estimated Total Annual Burden:
a. VA Form 10-5345--15,000 hours.
b. VA Form 10-5345a--15,000 hours.
c. VA Form 10-5345a-MVH--35,000 hours.
Estimated Average Burden per Respondent:
a. VA Form 10-5345--3 minutes.
b. VA Form 10-5345a--3 minutes.
c. VA Form 10-5345a-MVH--3 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
a. VA Form 10-5345--300,000.
b. VA Form 10-5345a--300,000.
c. 10-5345a-MVH--700,000.
Dated: September 2, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9-21574 Filed 9-8-09; 8:45 am]
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