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MI/SP Caller Initial Script
Monitoring of National Suicide Prevention Lifeline Form
OMB: 0930-0274
IC ID: 7689
OMB.report
HHS/SAMHSA
OMB 0930-0274
ICR 201302-0930-001
IC 7689
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0274 can be found here:
2016-06-22 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form CallerI Initial Sc
MI/SP Caller Initial Script
Form and Instruction
CallerI Initial Sc CallerI Initial Script
Attachment A_CallerI Initial Script.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
MI/SP Caller Initial Script
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
CallerI Initial Script
CallerI Initial Script
Attachment A_CallerI Initial Script.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:
500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
500
0
-2,936
0
0
3,436
Annual IC Time Burden (Hours)
40
0
-1,141
0
0
1,181
Annual IC Cost Burden (Dollars)
0
0
0
0
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.