Information Collection

Interview Guide for Other Stakeholders (Behavioral Health and Judicial Stakeholders)

IC 247725 under ICR 202106-0970-001 · OMB 0970-0575.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0575 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 3 - Interview Guide for Other Health Providers and Judicial Stakeholders.docx	Other-Interview Guide
Instrument 3 - Interview Guide for Other Health Providers and Judicial Stakeholders.docx	Other-Interview Guide

IC Title:

Interview Guide for Other Stakeholders (Behavioral Health and Judicial Stakeholders)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Interview Guide			Instrument 3 - Interview Guide for Other Health Providers and Judicial Stakeholders.docx		Yes	No	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4	4
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.