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Csap/csat Gpra
Government Performance and Results Act Client/Participant Outcome Measures
OMB: 0930-0208
IC ID: 178309
OMB.report
HHS/SAMHSA
OMB 0930-0208
ICR 200701-0930-004
IC 178309
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0208 can be found here:
2024-11-21 - Revision of a currently approved collection
2022-08-16 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form Attachment 1-1 CSA
CSAP/CSAT GPRA
Form and Instruction
Attachment 1-1 CSA Attachment 1-1 CSAT Instructions
1 Attachment 1-1 GPRA CSAT instructions 2006.doc
Form and Instruction
Attachment 2-1 CSA Attachment 2-1 CSAP Instructions
2 Attachment 2-1 GPRA CSAP instructions 2006.doc
Form and Instruction
Attachment 1-2 CSA Attachment 1-2 CSAT Instruments
1 Attachment 1-2 CSAT GPRA Client Outcome instrument.doc
Form and Instruction
Attachment 2-2 CSA Attachment 2-2 CSAP Instruments
2 Attachment 2-2 GPRA CSAP instrument.doc
Form and Instruction
3 Attachment 3 GPRA Matrix.doc
Attachment 3 - Matrix
IC Document
4 Attachment 4 Data Entry Screens.doc
Attachment 4 - Screens
IC Document
5 Attachment 5 Consent Form.doc
Attachment 5 - Consent Form
IC Document
6 Attachment 6 Reports.doc
Attachment 6 - Reports
IC Document
1 0208Terms Memo 1-3-07.doc
Terms of Clearance Memo
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
CSAP/CSAT GPRA
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
Attachment 1-1 CSAT Instructions
Attachment 1-1 CSAT Instructions
1 Attachment 1-1 GPRA CSAT instructions 2006.doc
No
No
Paper Only
Form and Instruction
Attachment 2-1 CSAP Instructions
Attachment 2-1 CSAP Instructions
2 Attachment 2-1 GPRA CSAP instructions 2006.doc
No
No
Paper Only
Form and Instruction
Attachment 1-2 CSAT Instruments
Attachment 1-2 CSAT Instruments
1 Attachment 1-2 CSAT GPRA Client Outcome instrument.doc
No
No
Paper Only
Form and Instruction
Attachment 2-2 CSAP Instruments
Attachment 2-2 CSAP Instruments
2 Attachment 2-2 GPRA CSAP instrument.doc
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
219,397
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
50 %
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
219,397
585,237
-365,840
0
0
0
Annual IC Time Burden (Hours)
13,853
0
13,853
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment 3 - Matrix
3 Attachment 3 GPRA Matrix.doc
01/08/2007
Attachment 4 - Screens
4 Attachment 4 Data Entry Screens.doc
01/08/2007
Attachment 5 - Consent Form
5 Attachment 5 Consent Form.doc
01/08/2007
Attachment 6 - Reports
6 Attachment 6 Reports.doc
01/08/2007
Terms of Clearance Memo
1 0208Terms Memo 1-3-07.doc
01/08/2007
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.