FIELD TEST OF SURVEY FORMS AND PROCEDURES FOR THE 1985 NIMH CLIENT/PATIENT SAMPLE SURVEY

ICR 198308-0930-003

OMB: 0930-0096

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
0930-0096 198308-0930-003
Historical Active
HHS/SAMHSA
FIELD TEST OF SURVEY FORMS AND PROCEDURES FOR THE 1985 NIMH CLIENT/PATIENT SAMPLE SURVEY
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/30/1983
Retrieve Notice of Action (NOA) 08/12/1983
  Inventory as of this Action Requested Previously Approved
05/31/1984 05/31/1984
120 0 0
720 0 0
0 0 0

THIS IS A FIELD TEST OF FORMS WHICH ARE INTENDED TO OBTAIN INFORMATION ABOUT THE CLIENTELE OF INPATIENT, OUTPATIENT AND PARTIAL CARE PROGRAMS OF MENTAL HEALTH ORGANIZATIONS, TO HELP MEET INFORMATION NEEDS OF NIMH DHHS, STATES, AND RESEARCHERS.

None
None


No

1
IC Title Form No. Form Name
FIELD TEST OF SURVEY FORMS AND PROCEDURES FOR THE 1985 NIMH CLIENT/PATIENT SAMPLE SURVEY

  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 120 0 0 120 0 0
Annual Time Burden (Hours) 720 0 0 720 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
08/12/1983


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