SMI Clients- Clients Exam and Survey-Follow-up

Evaluation of SAMHSA Primary Care Behavioral Health Integration Grant Program

OMB: 0930-0340

IC ID: 198669

Documents and Forms
Document Name
Document Type
Other-form
Information Collection (IC) Details

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SMI Clients- Clients Exam and Survey-Follow-up
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-form 0990-0371Attach 6 Client exam and survey.doc Yes Yes Fillable Fileable

Health Immunization Management

 

1,667 0
   
Individuals or Households
 
   0 %

  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 1,667 0 1,667 0 0 0
Annual IC Time Burden (Hours) 1,250 0 1,250 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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