Request for FL 10-490 inclusion under 2900-0621

The Veterans Affairs Credentialing and Privileging Office of Quality and Performance requests inclusion of this letter and release of information form (FL 10-490) to the OMB approved information collection for 2900-0621 (National Practitioner Data Bank (NPDB)). This particular verification information is currently being collected under this OMB number and the attached form would be presented as a supplemental written verification of said information collections to the Medical, Dental, and Nursing licensing boards.