OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

2021 Survey of Behavioral Health Workforce Providers

IC 246779 under ICR 202110-0930-003 · OMB 0930-0387.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

2021 Survey of Behavioral Health Workforce Providers
 
No Unchanged
 
Voluntary
 

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

Health Public Health Monitoring

2021 Survey of Behavioral Health Workforce Providers  75 FR 28264

5,000 0
   
State, Local, and Tribal Governments
 
   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 5,000 0 0 0 0 5,000
Annual IC Time Burden (Hours) 1,250 0 0 0 0 1,250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.