Adolescents - State/Tribal - Trainees

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⚠️ Notice: This information collection may be referencing outdated material.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 D7.Training Utiliz Adolescents - State/Tribal - Trainees Form and Instruction
D7.Training Utiliz D7.Training Utilization and Preservation Survey (TUP-S-A D7.Training Utilization and Preservation Survey (TUP-S-A)- Adolescent Version.docx Form and Instruction
D8. TUP-S-A Consen D8. TUP-S-A Consent-to-Contact and Youth Assent Forms.do D8. TUP-S-A Consent-to-Contact and Youth Assent Forms.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Adolescents - State/Tribal - Trainees	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	D7.Training Utilization and Preservation Survey	D7.Training Utilization and Preservation Survey (TUP-S-A)- Adolescent Version.docx	D7.Training Utilization and Preservation Survey (TUP-S-A)- Adolescent Version.docx		Yes	Yes	Fillable Fileable
Form and Instruction	D8. TUP-S-A Consent-to-Contact	D8. TUP-S-A Consent-to-Contact and Youth Assent Forms.docx	D8. TUP-S-A Consent-to-Contact and Youth Assent Forms.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	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	300	300
Annual IC Time Burden (Hours)	48	48
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.