Program Implementation Survey

Evaluation of the Maternal and Child Health Bureau Pediatric Mental Health Care Access and Screening and Treatment for Maternal Depression and Related Behavioral Disorders Programs Project

OMB: 0906-0052

IC ID: 239853

Information Collection (IC) Details

View Information Collection (IC)

Program Implementation Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3-1 PMHCA Program Implementation Survey_2-3-2020.docx Attachment B5 - PMHCA Program Implementation Survey_2-3-2020.docx Yes Yes Fillable Fileable
Form and Instruction 3-2 MDRBD Program Implementation Survey_2-3-2020.docx Attachment B6-MDRBD Program Implementation Survey_2-3-2020.docx Yes Yes Fillable Fileable

Health Health Care Services

 

28 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 84 0 84 0 0 0
Annual IC Time Burden (Hours) 28 0 28 0 0 0
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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