Individual/Family Crisis Counseling Servies Encounter Log

Toolkit Protocol for the Crisis Counseling Assistance and Training Program (CCP)

OMB: 0930-0270

IC ID: 7686

Information Collection (IC) Details

View Information Collection (IC)

Individual/Family Crisis Counseling Servies Encounter Log
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Individual_Family_Encounter_Form Individual_Family_Encounter_Form 3_20_15_Attachment A_Individual_Family_Encounter_Form.docx Yes Yes Fillable Fileable

Health Health Care Services

 

200 0
   
State, Local, and Tribal Governments
 
   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 39,200 0 0 0 0 39,200
Annual IC Time Burden (Hours) 5,096 0 0 0 0 5,096
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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