SAMHSA/CSAT's Viral Hepatitis Information Form

Enhancing Substance Abuse Treatment Services to Address Hepatitis Infection Among Intravenous Drug Users Hepatitis Testing and Vaccine Tracking Form

OMB: 0930-0300

IC ID: 188545

Information Collection (IC) Details

View Information Collection (IC)

SAMHSA/CSAT's Viral Hepatitis Information Form
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Viral Hepatitis Information Form Viral Hepatitis Information Form Hepatitis Information Form 2008 1-15-09.doc Yes Yes Paper Only

Health Public Health Monitoring

 

50,000 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 50,000 0 0 0 50,000 0
Annual IC Time Burden (Hours) 2,500 0 0 0 2,500 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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