Office of Regional Operations (ORO) 2016 Tele-Behavioral Health Webcase Series

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Office of Regional Operations (ORO) 2016 Tele-Behavioral Health Webcase Series Form
1 Telebehavioral Webinars - Questions FINAL 4-28-16 Telebehavioral Webinars - Questions FINAL 4-28-16.docx Form
BH Webinar Supporting Statement 042616 draft.docx Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	Office of Regional Operations (ORO) 2016 Tele-Behavioral Health Webcase Series	Agency IC Tracking Number:

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	1	Telebehavioral Webinars - Questions FINAL 4-28-16	Telebehavioral Webinars - Questions FINAL 4-28-16.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 90	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	BH Webinar Supporting Statement 042616 draft.docx	05/10/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.