Consumers with SMI at control sites

Evaluation of SAMHSA Primary Care Behavioral Health Integration Grant Program

OMB: 0990-0371

IC ID: 196129

Documents and Forms
Document Name
Document Type
Other-questions
Information Collection (IC) Details

View Information Collection (IC)

Consumers with SMI at control sites
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-questions 0990-PCBHI Attach 5 SiteVisit_Control (2).doc Yes No Paper Only

Health Illness Prevention

 

900 0
   
Individuals or Households
 
   0 %

  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 900 0 900 0 0 0
Annual IC Time Burden (Hours) 675 0 675 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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