Clinical Directors/Supervisors Tele Interviews

Addiction Technology Transfer Centers (ATTC) National Workforce Surveys

Documents and Forms

Document Name Document Type
Form Key Informant Tele Clinical Directors/Supervisors Tele Interviews Form and Instruction
Key Informant Tele Key Informant Tele Inter Questionnaire Attachment 3.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Clinical Directors/Supervisors Tele Interviews	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	Key Informant Tele Inter Questionnaire	Key Informant Tele Inter Questionnaire	Attachment 3.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	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.