Locator Survey 2018

2017-19 National Mental Health Services Survey (N-MHSS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0119 can be found here:

Documents and Forms

Document Name Document Type
Form Full Survey Questi Locator Survey 2018 Form and Instruction
Full Survey Questi Full Survey Questionnaire Attachment A.2 2018 N-MHSS Full Survey Questionnaire_120616.pdf Form and Instruction
Attachment A.4 BHSIS screenshots for OMB_2018_Full.pdf Web Screens IC Document

Information Collection (IC) Details

IC Title:	Locator Survey 2018	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	Full Survey Questionnaire	Full Survey Questionnaire	Attachment A.2 2018 N-MHSS Full Survey Questionnaire_120616.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 17,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	17,000	15,300	1,700
Annual IC Time Burden (Hours)	4,250	-2,890	7,140
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Web Screens	Attachment A.4 BHSIS screenshots for OMB_2018_Full.pdf	12/08/2016

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