CLIENT DATA REPORTING SYSTEM - OUTPATIENT AND PARTIAL CARE SERVICES

ICR 198007-0930-001

OMB: 0930-0046

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0930-0046 198007-0930-001
Historical Active 197911-0930-001
HHS/SAMHSA
CLIENT DATA REPORTING SYSTEM - OUTPATIENT AND PARTIAL CARE SERVICES
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 09/04/1980
Retrieve Notice of Action (NOA) 07/18/1980
  Inventory as of this Action Requested Previously Approved
08/31/1981 08/31/1981
1,500 0 0
3,184 0 0
0 0 0

DATA FROM THESE SURVEYS WILL PROVIDE NATIONAL ESTIMATES DESCRIBING THE MH RECIPIENTS OF OUTPATIENTS & PARTIAL CARE PROGRAMS IN SPECIALTY MH ORGANIZATIONS. THESE DATA PERMIT CONSIDERATION OF SUCH ISSUES AS EQUITY OR DIFFERENCE IN SERVICE DELIVER TO VARIOUS TARGET GROUP POPULATIONS IN AMBULATORY SETTINGS. THEY WILL BE USED IN CONJUNCTION WITH SURVEYS IF IMPATIENT SERVICES TO MORE FULLY DESCRIBE THE USE OF THE MH SYSTEM

None
None


No

1
IC Title Form No. Form Name
CLIENT DATA REPORTING SYSTEM - OUTPATIENT AND PARTIAL CARE SERVICES ADM 569-1, ADM 569-2, ADM 569-3A, ADM 569-3B, ADM 569-4, ADM 569-5, ADM 569-6A, ADM 569-6B

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,500 0 0 0 1,500 0
Annual Time Burden (Hours) 3,184 0 0 0 3,184 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/18/1980


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