FSR 210 SAMHSA NCAID and Mental Health

Customer Satisfaction Measure of Government Websites

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0186 can be found here:

Documents and Forms

Document Name Document Type
Form FSR 210 FSR 210 SAMHSA NCAID and Mental Health Form
FSR 210 SAMHSA NCAID and Mental Health FSR 210 SAMSHA Mental Health and NCADI questionnaire.xls Form

Information Collection (IC) Details

IC Title:	FSR 210 SAMHSA NCAID and Mental Health	Agency IC Tracking Number:	FSR 210

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	FSR 210	SAMHSA NCAID and Mental Health	FSR 210 SAMSHA Mental Health and NCADI questionnaire.xls		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	5,000	0	0	0	0	0
Annual IC Time Burden (Hours)	208	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.