NASTAD Strengthening SSPs Evaluation: Baseline

[NCHHSTP] PS22-2208 Component 2 (Strengthening Syringe Services Programs) Program Evaluation

Documents and Forms

Document Name Document Type
Form 0920 NASTAD Strengthening SSPs Evaluation: Baseline Form and Instruction
0920 NASTAD Strengthening SSPs Evaluation: Baseline Attachment 4_NASTAD's Strengthening SSPs Baseline Survey.docx Form and Instruction
Attachment 2_NASTAD Baseline Survey Invitation.pdf NASTAD Baseline Survey Invitation IC Document
Attachment 6_Screenshots of Program Evaluation for PS22-2208 Component 2 Baseline Survey.docx NASTAD Strengthening SSPs Evaluation: Baseline (screenshots) IC Document

Information Collection (IC) Details

IC Title:	NASTAD Strengthening SSPs Evaluation: Baseline	Agency IC Tracking Number:	0920-23HS

Is this a Common Form? No		IC Status: New

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	0920	NASTAD Strengthening SSPs Evaluation: Baseline	Attachment 4_NASTAD's Strengthening SSPs Baseline Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	83	83
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NASTAD Baseline Survey Invitation	Attachment 2_NASTAD Baseline Survey Invitation.pdf	05/02/2024
NASTAD Strengthening SSPs Evaluation: Baseline (screenshots)	Attachment 6_Screenshots of Program Evaluation for PS22-2208 Component 2 Baseline Survey.docx	05/02/2024

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