[Federal Register Volume 72, Number 228 (Wednesday, November 28, 2007)]
[Notices]
[Page 67347]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-23099]


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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. 3501-3521), this notice announces that the Veterans Health 
Administration (VHA), Department of Veterans Affairs, will submit 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 and includes the actual data collection instrument.

DATES: Comments must be submitted on or before December 28, 2007.

ADDRESSES: Submit written comments on the collection of information 
through http://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. 2900-0260'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Denise McLamb, Records Management 
Service (005G2), Department of Veterans Affairs, 810 Vermont Avenue, 
NW., Washington, DC 20420, (202) 461-7485, fax (202) 273-0443 or e-mail 
[email protected]. Please refer to ``OMB Control No. 2900-
0260.''

SUPPLEMENTARY INFORMATION:
    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.
    OMB Control Number: 2900-0260.
    Type of Review: Extension 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 10-5345 to request a copy of their 
medical records from the Department of Veterans Affairs.
    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 September 12, 2007 at pages 52201-52202.
    Affected Public: Business or other for profit, Individuals or 
households, and not for profit institutions.
    Estimated Total Annual Burden:
    a. VA Form 10-5345--16,667 hours.
    b. VA Form 10-5345a--16,667 hours.
    Estimated Average Burden Per Respondent:
    a. VA Form 10-5345--2 minutes.
    b. VA Form 10-5345a--2 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents:
    a. VA Form 10-5345--29,667.
    b. VA Form 10-5345a--29,667.

    Dated: November 19, 2007.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Records Management Service.
[FR Doc. E7-23099 Filed 11-27-07; 8:45 am]
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