Session Report Form

Center for Mental Health Services
Session Reporting Form
Instructions
Instructions to Agency Staff/Trainers
The Center for Mental Health Services (CMHS) is committed to improving the
mental health services delivered to HIV/AIDS affected populations and requests
that you complete the attached Session Reporting Form. This form requests
descriptive information on the education/training session and must be completed
by agency staff or trainers at the end of each training session. The information
collected will enable CMHS to evaluate the effectiveness of the effort in
meeting its objectives to provide state-of-the-art information to a diverse
mixture of training participants. CMHS and the sponsoring agency intend to use
the information gathered from the evaluation to improve the quality of training
and to ensure continued funding for HIV/AIDS provider education programs.
Public reporting burden for this collection of information is estimated to average
5 minutes per response, including time for reviewing instructions and
completing the survey form. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for
reducing this burden to SAMHSA Reports Clearance Officer; Paperwork
Reduction Project (0930-0195); Room 16-105, Parklawn Building; 5600 Fishers
Lane, Rockville, MD 20857. An agency may not conduct or sponsor and a
person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. The OMB control number for
this project is 0930-0195.
Thank you, your help is appreciated.

Substance Abuse and Mental Health Services Administration

Mental Health Care Provider
Education in HIV/AIDS
Program