Information Collection Request

Pediatric Mental Health Care Access Program National Impact Study

ICR 202502-0906-001 · OMB 0906-0097 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1 Health Professional Impact Survey Form and Instruction Unchanged Available
Form 1 Health Professional Impact Survey Form and Instruction Unchanged Repair queued
Form 2 Family/Caregiver Focus Group Discussion Form and Instruction Unchanged Available
Form 2 Family/Caregiver Focus Group Discussion Form and Instruction Unchanged Missing upstream
Form 3_Revised Family/Caregiver Demographic Questionnaire Form and Instruction Modified Available
Form 3_Revised Family/Caregiver Demographic Questionnaire Form and Instruction Modified Missing upstream
0906-0097_MCHB_OMB NonSubstantive Change Request_02252025.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-03-14 Available
0906-0097_MCHB_OMB NonSubstantive Change Request_02252025.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-03-14 Repair queued
Attachment B7 - Family-Caregiver Pilot Feedback_Final.docx Supplementary Document Uploaded 2024-04-30 Available
Attachment B7 - Family-Caregiver Pilot Feedback_Final.docx Supplementary Document Uploaded 2024-04-30 Repair queued
Attachment B6 - HP Impact Survey Pilot Feedback_Final.docx Supplementary Document Uploaded 2024-04-30 Available
Attachment B6 - HP Impact Survey Pilot Feedback_Final.docx Supplementary Document Uploaded 2024-04-30 Repair queued
Attachment A12 - IRB Decision Letter.pdf Supplementary Document Uploaded 2024-04-30 Available
Attachment A12 - IRB Decision Letter.pdf Supplementary Document Uploaded 2024-04-30 Repair queued
Attachment A11 - PMHCA FGD Flyer_Final.pdf Supplementary Document Uploaded 2024-04-30 Available
Attachment A11 - PMHCA FGD Flyer_Final.pdf Supplementary Document Uploaded 2024-04-30 Missing upstream
Attachment A10 - PMHCA FGD Overview Guide_Final.docx Supplementary Document Uploaded 2024-04-30 Available
Attachment A10 - PMHCA FGD Overview Guide_Final.docx Supplementary Document Uploaded 2024-04-30 Repair queued
Attachment A9 - PMHCA FGD Recruitment Procedures_Final.docx Supplementary Document Uploaded 2024-04-30 Available
Attachment A9 - PMHCA FGD Recruitment Procedures_Final.docx Supplementary Document Uploaded 2024-04-30 Repair queued
Attachment A8 - PMHCA FGD Recruiter Email From JBS_Final.docx Supplementary Document Uploaded 2024-04-30 Available
Attachment A8 - PMHCA FGD Recruiter Email From JBS_Final.docx Supplementary Document Uploaded 2024-04-30 Repair queued
Attachment A7 - PMHCA HP Survey Reminder Email From Program_Final.docx Supplementary Document Uploaded 2024-04-30 Repair queued
Attachment A7 - PMHCA HP Survey Reminder Email From Program_Final.docx Supplementary Document Uploaded 2024-04-30 Repair queued
Attachment A6 - PMHCA HP Survey Participation Email From Program_Final.docx Supplementary Document Uploaded 2024-04-30 Available
Attachment A6 - PMHCA HP Survey Participation Email From Program_Final.docx Supplementary Document Uploaded 2024-04-30 Repair queued
Attachment A5 - PMHCA HP Survey Reminder Email From JBS_Final.docx Supplementary Document Uploaded 2024-04-30 Available
Attachment A5 - PMHCA HP Survey Reminder Email From JBS_Final.docx Supplementary Document Uploaded 2024-04-30 Repair queued
Attachment A4 - PMHCA HP Survey Participation Email From JBS_Final.docx Supplementary Document Uploaded 2024-04-30 Available
Attachment A4 - PMHCA HP Survey Participation Email From JBS_Final.docx Supplementary Document Uploaded 2024-04-30 Repair queued
Attachment A1 - Legislation_Final.docx Supplementary Document Uploaded 2024-04-30 Available
Attachment A1 - Legislation_Final.docx Supplementary Document Uploaded 2024-04-30 Missing upstream
Attachment A2 - 60-day FRN Publication_Final.pdf Supplementary Document Uploaded 2024-04-30 Available
Attachment A2 - 60-day FRN Publication_Final.pdf Supplementary Document Uploaded 2024-04-30 Missing upstream
Supporting Statement B- MCHB- PMHCA- New- 04302024.docx Supporting Statement B Uploaded 2024-04-30 Available
Supporting Statement B- MCHB- PMHCA- New- 04302024.docx Supporting Statement B Uploaded 2024-04-30 Repair queued
Supporting Statement A- MCHB- PMHCA- New - OIRA- JBS- Clean 07182024.docx Supporting Statement A Uploaded 2024-07-18 Available
Supporting Statement A- MCHB- PMHCA- New - OIRA- JBS- Clean 07182024.docx Supporting Statement A Uploaded 2024-07-18 Missing upstream
IC Document Collections
IC IDCollectionTypeStatusForm
267354 Health Professional Impact Survey Form and Instruction Unchanged
267354 Health Professional Impact Survey Form and Instruction Unchanged
267352 Family/Caregiver Focus Group Discussion Form and Instruction Unchanged
267352 Family/Caregiver Focus Group Discussion Form and Instruction Unchanged
267351 Family/Caregiver Demographic Questionnaire Form and Instruction Modified
267351 Family/Caregiver Demographic Questionnaire Form and Instruction Modified
ICR Details
StatusActive
Agency/SubagencyHHS/HRSA
OMB Control No0906-0097
Type of Information CollectionNo material or nonsubstantive change to a currently approved collection
Previous ICR Reference No202404-0906-009
Date Submitted to OIRA2025-03-28
Requested Expiration Date1969-12-31