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Are you of Spanish Hispanic or Latino origin or descent No not Spanish/Hispanic/Latino Yes Puerto Rican Yes Mexican Mexican American Chicano Yes Cuban Yes other Spanish/Hispanic/Latino 54. What is your race Please choose one or more. White Black or African American Asian Native Hawaiian or other Pacific Islander American Indian or Alaska Native 55. OMB Number 2900-0712 Est. Burden 16 minutes Exp. Date 03/31/2017 VA Form 10-1465-2 SURVEY OF HEALTHCARE EXPERIENCES OF PATIENTS RECENTLY...
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What is omb number 2900-0712?
The OMB number 2900-0712 refers to the form used by the Department of Veterans Affairs for health care applications.
Who is required to file omb number 2900-0712?
Veterans who are applying for health care services from the Department of Veterans Affairs are required to file OMB number 2900-0712.
How to fill out omb number 2900-0712?
To fill out OMB number 2900-0712, veterans must provide personal information, details of military service, health insurance information, and consent for treatment.
What is the purpose of omb number 2900-0712?
The purpose of OMB number 2900-0712 is to collect necessary information from veterans to determine their eligibility for health care services from the Department of Veterans Affairs.
What information must be reported on omb number 2900-0712?
OMB number 2900-0712 requires information such as personal details, military service history, health insurance details, and consent for treatment.
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