Information Collection

Identification of Current Infant and Early Childhood Mental Health Consultation (IECMHC) Services and Points of Contact Across the U.S. and U.S. Territories.

IC 271784 under ICR 202412-0970-005 · OMB 0970-0531.

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 1- IECMHC Scan Survey Draft_v1_ Provider_For Sharing_10.2.24_clean version.docx Yes Yes Fillable Fileable
Other-Survey 2 - OCC survey_10.3.24_clean version.docx Yes Yes Fillable Fileable
Other-Survey 3 - IECMHC Scan Survey-Draft-v1-Head Start_ 10.18.24_clean version.docx Yes Yes Fillable Fileable
Other-Interview Protocol 4 - Interview Protocol Description_10.3.24_clean version.docx Yes Yes Printable Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 271 0 0 0 0 271
Annual IC Time Burden (Hours) 159 0 0 0 0 159
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
SSA - Prog Supp GenIC: IECMHC Services and Points of Contact Across the U.S. and U.S. Territories. SSA - Formative for ACF Program Support_IECMHC GenIC_10.21.24_clean version.docx 10/22/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.