Harm Reduction Point in Time Survey

Generic Clearance for the Collection of Qualitative Research and Assessment

Documents and Forms

Document Name Document Type
Form PiT Grantee Planni Harm Reduction Point in Time Survey Form and Instruction
PiT Grantee Planni PiT Grantee Planning Tool and Email Invite Harm Reduction-Invite and Survey_PEERS_CLEAN.docx Form and Instruction
Harm Reduction-Request_PEERS_CLEAN.docx Harm Reducation PiT Generic Template IC Document

Information Collection (IC) Details

IC Title:	Harm Reduction Point in Time Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 1320.8(d)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	PiT Grantee Planning Tool and Email Invite	PiT Grantee Planning Tool and Email Invite	Harm Reduction-Invite and Survey_PEERS_CLEAN.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Privacy Act of 1974 (Title 5 United States Code [U.S.C.] 552a)	FR Citation: 75 FR 28264

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Harm Reducation PiT Generic Template	Harm Reduction-Request_PEERS_CLEAN.docx	02/07/2024

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