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The Nat'l Eval. of theComprehensive Community MH Services for Children - Caregivers
National Evaluation of the Comprehensive Mental Health Services for Children and Their Families Program: Phase VI
OMB: 0930-0307
IC ID: 190420
OMB.report
HHS/SAMHSA
OMB 0930-0307
ICR 201206-0930-002
IC 190420
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0307 can be found here:
2015-03-26 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Caregiver-Instrume
The Nat'l Eval. of theComprehensive Community MH Services for Children - Caregivers
Form and Instruction
Caregiver-Instrume Caregiver-Instruments
Caregiver--Instruments.pdf
Form and Instruction
Consultation.pdf
Consultation
IC Document
Caregiver--Other.pdf
Caregiver--Other
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
The Nat'l Eval. of theComprehensive Community MH Services for Children - Caregivers
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
Caregiver-Instruments
Caregiver-Instruments
Caregiver--Instruments.pdf
Yes
Yes
Fillable Printable
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:
6,561
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 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
67,039
0
-11,533
0
0
78,572
Annual IC Time Burden (Hours)
21,397
0
6,444
0
0
14,953
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Consultation
Consultation.pdf
09/10/2012
Caregiver--Other
Caregiver--Other.pdf
09/10/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.