Information Collection

Mental Health Professional

IC 205351 under ICR 201511-0990-001 · OMB 0990-0407.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0407 can be found here:

Documents and Forms

Document Name Document Type
0990-OS think__Please refer back to Physicians for the forms.docx Other-instrument

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Mental Health Professional	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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
Other-instrument			0990-OS think__Please refer back to Physicians for the forms.docx		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 180	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-180	180
Annual IC Time Burden (Hours)	-9	9
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.