Information Collection

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

IC 251141 under ICR 202301-0970-001 · OMB 0970-0401.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
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
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

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: Unchanged

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-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 %

table that charts list of burden
	Requested	Previously Approved
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

table that charts IC Documents
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.