Survey

SUD Placement Criteria Survey

OMB: 0990-0474

IC ID: 241655

Documents and Forms
Document Name
Document Type
Other-survey
Information Collection (IC) Details

View Information Collection (IC)

Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-survey 3. Attachment A - Survey 7-23-2020 CLEAN.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

87 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 87 0 87 0 0 0
Annual IC Time Burden (Hours) 15 0 15 0 0 0
Annual IC Cost Burden (Dollars) 793 0 793 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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