Standard Feedback Survey for the National Center for Health, Behavioral Health, and Safety's Training and Technical Assistance Offerings

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Document Name Document Type
TTA standard feedback survey_revised for OMB review_1.12.22-clean.docx Other-Survey
TTA standard feedback survey_revised for OMB review_1.12.22-clean.docx Other-Survey
OMB form_revised Standard Survey_1.12.22-clean.docx Updated Submission Form - Standard Feedback Survey for the NCHBHS TTA Offerings IC Document
OMB form_revised Standard Survey_1.12.22-clean.docx Updated Submission Form - Standard Feedback Survey for the NCHBHS TTA Offerings IC Document
NonSub Change Request Memo-IECMHC Office Hours Feedback Form-1.12.22.docx NonSub Change Request - Standard Feedback Survey for the NCHBHS TTA Offerings IC Document
NonSub Change Request Memo-IECMHC Office Hours Feedback Form-1.12.22.docx NonSub Change Request - Standard Feedback Survey for the NCHBHS TTA Offerings IC Document
NOA - NC HBHS TTA_FastTrack GenIC_0970-0401_2.12.21.pdf NOA for previous approval of Standard Feedback Survey for the NCHBHS TTA Offerings IC Document
NOA - NC HBHS TTA_FastTrack GenIC_0970-0401_2.12.21.pdf NOA for previous approval of Standard Feedback Survey for the NCHBHS TTA Offerings IC Document

Information Collection (IC) Details

IC Title:	Standard Feedback Survey for the National Center for Health, Behavioral Health, and Safety's Training and Technical Assistance Offerings	Agency IC Tracking Number:	OHS

IC Status: New

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
Other-Survey			TTA standard feedback survey_revised for OMB review_1.12.22-clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 63,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	63,000	63,000
Annual IC Time Burden (Hours)	5,250	5,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Updated Submission Form - Standard Feedback Survey for the NCHBHS TTA Offerings	OMB form_revised Standard Survey_1.12.22-clean.docx	01/13/2022
NonSub Change Request - Standard Feedback Survey for the NCHBHS TTA Offerings	NonSub Change Request Memo-IECMHC Office Hours Feedback Form-1.12.22.docx	01/13/2022
NOA for previous approval of Standard Feedback Survey for the NCHBHS TTA Offerings	NOA - NC HBHS TTA_FastTrack GenIC_0970-0401_2.12.21.pdf	01/13/2022

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