Counselor Follow-up Questionnaire

Monitoring of National Suicide Prevention Lifeline Form

OMB: 0930-0274

IC ID: 205813

Information Collection (IC) Details

View Information Collection (IC)

Counselor Follow-up Questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Counselor Questionnaire Counselor Questionnaire Attachment D. Counselor Questionnaire 031616.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

42 0
   
Individuals or Households
 
   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 630 0 -620 0 0 1,250
Annual IC Time Burden (Hours) 107 0 -106 0 0 213
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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