2021 Survey of Behavioral Health Workforce Providers

2021 Behavioral Health Workforce Surveys

Documents and Forms

Document Name Document Type
Form Provider Survey Qu 2021 Survey of Behavioral Health Workforce Providers Form and Instruction
Provider Survey Qu Provider Survey Questionnaire 7/21/2021 Survey Provider_Clean_OMB_FINAL.docx Form and Instruction
Provider Survey Qu Provider Survey Questionnaire 7/21/2021 Survey Provider_Clean_OMB_FINAL.docx Form and Instruction
08B ProviderSurvey_ICF.docx ProviderSurvey_ICF IC Document
08B ProviderSurvey_ICF.docx ProviderSurvey_ICF IC Document

Information Collection (IC) Details

IC Title:	2021 Survey of Behavioral Health Workforce Providers	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	Provider Survey Questionnaire 7/21/2021	Provider Survey Questionnaire 7/21/2021	Survey Provider_Clean_OMB_FINAL.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 2021 Survey of Behavioral Health Workforce Providers	FR Citation: 75 FR 28264

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	1,250	1,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
ProviderSurvey_ICF	08B ProviderSurvey_ICF.docx	04/13/2021

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