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Participant Feedback Forms for the Mental Health Care Provider Education (MHCPE) in the HIV/AIDS Program
Participant Feedback Forms for the Mental Health Care Provider Education (MHCPE) in the HIV/AIDS Program
OMB: 0930-0195
IC ID: 7583
OMB.report
HHS/SAMHSA
OMB 0930-0195
ICR 200711-0930-003
IC 7583
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0195 can be found here:
2017-05-25 - Extension without change of a currently approved collection
2014-03-13 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Forms and Instruct
Participant Feedback Forms for the Mental Health Care Provider Education (MHCPE) in the HIV/AIDS Program
Form and Instruction
Forms and Instruct Forms and Instructions
Forms-Instructions.zip
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Participant Feedback Forms for the Mental Health Care Provider Education (MHCPE) in the HIV/AIDS Program
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Forms and Instructions
Forms and Instructions
Forms-Instructions.zip
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
12,600
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
12,600
0
0
0
0
12,600
Annual IC Time Burden (Hours)
1,843
0
0
0
0
1,843
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.