[Federal Register Volume 66, Number 162 (Tuesday, August 21, 2001)]
[Notices]
[Page 43960]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-20990]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0260]


Agency Information Collection Activities Under OMB Review

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 
(44 U.S.C., 3501 et seq.), this notice announces that the Veterans 
Health Administration (VHA), Department of Veterans Affairs, has 
submitted the 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; it includes the actual data collection 
instrument.

DATES: Comments must be submitted on or before September 20, 2001.

FOR FURTHER INFORMATION OR A COPY OF THE SUBMISSION CONTACT: Denise 
McLamb, Information Management Service (045A4), Department of Veterans 
Affairs, 810 Vermont Avenue, NW, Washington, DC 20420, (202) 273-8030 
or FAX (202) 273-5981 or e-mail [email protected]. Please refer 
to ``OMB Control No. 2900-0260.''

SUPPLEMENTARY INFORMATION:
    Title: Request for and Consent to Release of Medical Records 
Protected by 38 U.S.C. 7332, VA Form 10-5345.
    OMB Control Number: 2900-0260.
    Type of Review: Extension of a currently approved collection.
    Abstract: VA Form 10-5345 is used to obtain prior written consent 
from a patient before information concerning treatment for alcoholism 
or alcohol abuse, drug abuse, sickle cell anemia, or infection with the 
human immunodeficiency virus (HIV) can be disclosed from his or her 
medical record. This special consent must indicate the name of the 
facility permitted to make the disclosure, name of the individual or 
organization to whom the information is being released, specify the 
particular records or information to be released, and be under the 
signature of the veteran. It must reflect the purpose for which the 
information is to be used, and include a statement that the consent is 
subject to revocation and the date, event or condition upon which the 
consent will expire if not revoked before.
    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 4, 2001, at pages 30048-30049.
    Affected Public: Business or other for profit, Individuals or 
households.
    Estimated Total Annual Burden: 10,867 hours.
    Estimated Average Burden Per Respondent: 2 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 326,000.
    Send comments and recommendations concerning any aspect of the 
information collection 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. 
2900-0260'' in any correspondence.

    Dated: August 10, 2001.

    By direction of the Secretary.
Donald L. Neilson,
Director, Information Management Service.
[FR Doc. 01-20990 Filed 8-20-01; 8:45 am]
BILLING CODE 8320-01-P