Practice-Level Survey

Evaluation of the Maternal and Child Health Bureau Pediatric Mental Health Care Access and Screening and Treatment for Maternal Depression and Related Behavioral Disorders Programs Project

OMB: 0906-0052

IC ID: 239852

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

View Information Collection (IC)

Practice-Level Survey
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2-1 PMHCA Practice Level Survey_2-3-2020.docx Attachment B3 - PMHCA Practice Level Survey_2-3-2020.docx Yes Yes Fillable Fileable
Form and Instruction 2-2 MDRBD Practice Level Survey 2-3-2020.docx Attachment B4-MDRBD Practice Level Survey 2-3-2020.docx Yes Yes Fillable Fileable

Health Health Care Services

 

4,165 4,165
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 12,495 0 0 0 0 12,495
Annual IC Time Burden (Hours) 3,124 0 0 0 0 3,124
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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