CMHS NOMS Data Collection Tool

Mental Health Client/Consumer Outcome Measures and Infrastructure, Prevention and Promotion Indicators

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0285 can be found here:

Documents and Forms

Document Name Document Type
Form CMHS NOMS Data Col CMHS NOMS Data Collection Tool Form and Instruction
CMHS NOMS Data Col CMHS NOMS Data Collection Tool Attachment A-NOMS Data Collection Tool.docx Form and Instruction
CMHS NOMS Data Col CMHS NOMS Data Collection Tool Attachment A-NOMS Data Collection Tool.docx Form and Instruction

Information Collection (IC) Details

IC Title:	CMHS NOMS Data Collection Tool	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	CMHS NOMS Data Collection Tool	CMHS NOMS Data Collection Tool	Attachment A-NOMS Data Collection Tool.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: CMHS NOMS Data Collection Tool	FR Citation: 75 FR 28264

Number of Respondents: 141,259	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	154,059	154,059
Annual IC Time Burden (Hours)	68,673	68,673
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.