Pilot Testing in Opioid Treatment Programs (OTPs) of Modular Survey with OTP-Speicfic Questions

Voluntary Customer Satisfaction Surveys to Implement Executive Order 12862 in the Substance Abuse and Mental Health Services Administration (SAMHSA)

OMB: 0930-0197

IC ID: 191756

Information Collection (IC) Details

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Pilot Testing in Opioid Treatment Programs (OTPs) of Modular Survey with OTP-Speicfic Questions
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Modular Survey - OTP Questions Modular Survey - OTP Questions Attachment 1 - Modular Survey Instrument with OTP Questions 12-18-09 ag.doc Yes Yes Paper Only

Health Public Health Monitoring

 

1,200 0
   
State, Local, and Tribal Governments
 
   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 1,200 0 0 0 0 0
Annual IC Time Burden (Hours) 300 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Justification OTP Modular Survey OMB 12-18-09 ag.doc 01/07/2010
Letter OMBTransLet10-2009.wpd 01/07/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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