Socess

Children’s Mental Health Initiative National Evaluation

Documents and Forms

Document Name Document Type
Form System of Care Exp SOCESS Form and Instruction
System of Care Exp System of Care Expansion and Sustainability Survey Attachment 3 System of Care Expansion and Sustainability Survey (SOCESS) 10-06-2016.docx Form and Instruction

Information Collection (IC) Details

IC Title:	SOCESS	Agency IC Tracking Number:

Is this a Common Form? No		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 and Instruction	System of Care Expansion and Sustainability Survey	System of Care Expansion and Sustainability Survey	Attachment 3 System of Care Expansion and Sustainability Survey (SOCESS) 10-06-2016.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,422	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,422	1,422
Annual IC Time Burden (Hours)	948	948
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.