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Baseline Survey
Upstream risk factors for behavioral health and suicide in military personnel: An examination of social determinants of health
OMB:
IC ID: 273472
OMB.report
NAVY
ICR 202501-0703-001
IC 273472
( )
Documents and Forms
Document Name
Document Type
SDOH BL 19DEC2024.pdf
Other-Survey
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Baseline Survey
Agency IC Tracking Number:
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
Other-Survey
SDOH BL 19DEC2024.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Defense and National Security
Subfunction:
Operational Defense
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,088
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
1,088
0
1,088
0
0
0
Annual IC Time Burden (Hours)
272
0
272
0
0
0
Annual IC Cost Burden (Dollars)
4,132
0
4,132
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.