Student - Campus

Cross-Site Evaluation of the Garrett Lee Smith Memorial Suicide Prevention and Early Intervention Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0286 can be found here:

Documents and Forms

Document Name Document Type
Form I2. LAFI Consent t Student - Campus Form and Instruction
J.1 SAIS Baseline J.1 SAIS Baseline Instrument and Web Consent.docx J.1 SAIS Baseline Instrument and Web Consent.docx Form and Instruction
J.2 SAIS Follow-up J.2 SAIS Follow-up Instrument and Web Consent.docx J.2 SAIS Follow-up Instrument and Web Consent.docx Form and Instruction
D5. TUP-S Campus C D5. TUP-S Campus Consent-to-Contact Form.docx D5. TUP-S Campus Consent-to-Contact Form.docx Form and Instruction
D6. TUP-S Campus V D6. TUP-S Campus Verbal Consent.doc D6. TUP-S Campus Verbal Consent.doc Form and Instruction
I1. LAFI Instrumen I1. LAFI Instrument.doc I1. LAFI Instrument.doc Form and Instruction
I3. LAFI Verbal Co I3. LAFI Verbal Consent Script.doc I3. LAFI Verbal Consent Script.doc Form and Instruction
I2. LAFI Consent t I2. LAFI Consent to Contact Form.doc I2. LAFI Consent to Contact Form.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Student - Campus	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	I2. LAFI Consent to Contact Form.doc	I2. LAFI Consent to Contact Form.doc	I2. LAFI Consent to Contact Form.doc	Yes	Yes	Fillable Fileable
Form and Instruction	J.1 SAIS Baseline Instrument and Web Consent.docx	J.1 SAIS Baseline Instrument and Web Consent.docx	J.1 SAIS Baseline Instrument and Web Consent.docx	Yes	Yes	Fillable Fileable
Form and Instruction	J.2 SAIS Follow-up Instrument and Web Consent.docx	J.2 SAIS Follow-up Instrument and Web Consent.docx	J.2 SAIS Follow-up Instrument and Web Consent.docx	Yes	Yes	Fillable Fileable
Form and Instruction	D5. TUP-S Campus Consent-to-Contact Form.docx	D5. TUP-S Campus Consent-to-Contact Form.docx	D5. TUP-S Campus Consent-to-Contact Form.docx	Yes	Yes	Fillable Fileable
Form and Instruction	D6. TUP-S Campus Verbal Consent.doc	D6. TUP-S Campus Verbal Consent.doc	D6. TUP-S Campus Verbal Consent.doc	Yes	Yes	Fillable Fileable
Form and Instruction	I1. LAFI Instrument.doc	I1. LAFI Instrument.doc	I1. LAFI Instrument.doc	Yes	Yes	Fillable Fileable
Form and Instruction	I3. LAFI Verbal Consent Script.doc	I3. LAFI Verbal Consent Script.doc	I3. LAFI Verbal Consent Script.doc	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,202	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	Previously Approved
Annual Number of Responses for this IC	8,802	-6,474	15,276
Annual IC Time Burden (Hours)	3,709	488	3,221
Annual IC Cost Burden (Dollars)	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.