Information Collection

Client Focus Groups

IC 255616 under ICR 202208-0990-007 · OMB 0990-0485.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment E. CCBHC Client Focus Group Protocol.docx	Other-Focus Group Protocol
Attachment E. CCBHC Client Focus Group Protocol.docx	Other-Focus Group Protocol
Attachment F. CCBHC Client Focus Group Consent Form.docx Client Focus Group Consent	IC Document
Attachment F. CCBHC Client Focus Group Consent Form.docx Client Focus Group Consent	IC Document

IC Title:

Client Focus Groups

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Focus Group Protocol			Attachment E. CCBHC Client Focus Group Protocol.docx		No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	14	14
Annual IC Time Burden (Hours)	14	14
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Client Focus Group Consent	Attachment F. CCBHC Client Focus Group Consent Form.docx	08/25/2022

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