National Cross-Site Assessment of Addiction Technology Transfer Centers (ATTC) Network

National Cross-Site Assessment of Addiction Technology Transfer Centers (ATTC) Network

OMB: 0930-0216

IC ID: 7618

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

National Cross-Site Assessment of Addiction Technology Transfer Centers (ATTC) Network
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1.1 ATTC Event Description Form ATTC Event Description Form Attachment 1-1 ATTC Event Description Form.doc No No Paper Only
Form and Instruction 1.2 ATTC Pre-Event Form Meetings & TA ATTC Pre-Event Form Meetings & TA Attachment 1-2 ATTC PreEvent Form Meetings & TA.doc No No Paper Only
Form and Instruction 1.3 ATTC Pre-Event Form Training ATTC Pre-Event Form Training Attachment 1-3 ATTC PreEvent Form Training.doc No No Paper Only
Form and Instruction 2.4 CSAT Customer Sat Survey TA Follow-up CSAT Customer Sat Survey TA Follow-up Attachment 2-4 CSAT Cust Satis Survey TA Followup.doc No No Paper Only
Form and Instruction 1.5 ATTC Follow-up Event Cust Sat Survey Training ATTC Follow-up Event Cust Sat Survey Training Attachment 1-5 ATTC FollowUp Customer Satis Survey Training.doc No No Paper Only
Form and Instruction 2.1 CSAT Customer Sat Survey Meeting CSAT Customer Sat Survey Meeting Attachment 2-1 CSAT Cust Satis Survey Meeting.doc No No Paper Only
Form and Instruction 2.2 CSAT Customer Sat Survey Meeting Follow-up CSAT Customer Sat Survey Meeting Follow-up Attachment 2-2 CSAT Cust Satis Survey Meeting Followup.doc No No Paper Only
Form and Instruction 2.3 CSAT Customer Sat Survey TA CSAT Customer Sat Survey TA Attachment 2-3 CSAT Cust Satis Survey TA.doc No No Paper Only
Form and Instruction 2.5 CSAT Customer Sat Survey Training CSAT Customer Sat Survey Training Attachment 2-5 CSAT Cust Satis Survey Training.doc No No Paper Only
Form and Instruction 2.6 CSAT Customer Sat Survey Training Follow-up CSAT Customer Sat Survey Training Follow-up Attachment 2-6 CSAT Cust Satis Survey Training Followup.doc No No Paper Only
Form and Instruction 1.4 ATTC Post Event Cust Sat Survey Training ATTC Post Event Cust Sat Survey Training Attachment 1-4 ATTC PostEvent Customer Satis Survey Training.doc No No Paper Only

Health Health Care Services

 

200 0
   
Private Sector Not-for-profit institutions
 
   10 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 200 2,190 -27,440 2,190 0 23,260
Annual IC Time Burden (Hours) 50 0 -6,960 0 0 7,010
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment 3 ATTC Net Reg Centers Attachment 3 ATTC Network Regional Centers.doc 12/28/2006
Attachment 4 Sample Cover Letters Attachment 4 Sample Cover Letters.doc 12/28/2006
Attachment 5 Cover Page Instructions Attachment 5 Cover page for instruments.doc 12/28/2006
Attachment 6 Model Statement Attachment 6 Model Statement.doc 12/28/2006
Attachment 7 Contact Information Form Attachment 7 Contact Information Form.doc 12/28/2006
Attachment 8 Statement of Informed Consent Attachment 8 Statement of Informed Consent for Followup.doc 12/28/2006
Terms Memo Terms-06-Memo.doc 12/28/2006
Terms Report Terms-06-Report.doc 12/28/2006
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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