Pediatric Mental Health Care Access Program National Impact Study

ICR 202502-0906-001

OMB: 0906-0097

Federal Form Document

Forms and Documents

Document Name	Status
Form 1 Health Professional Impact Survey Form and Instruction	Unchanged
Form 2 Family/Caregiver Focus Group Discussion Form and Instruction	Unchanged
Form 3_Revised Family/Caregiver Demographic Questionnaire Form and Instruction	Modified
0906-0097_MCHB_OMB NonSubstantive Change Request_02252025.docx Justification for No Material/Nonsubstantive Change	2025-03-14
Attachment B7 - Family-Caregiver Pilot Feedback_Final.docx Supplementary Document	2024-04-30
Attachment B6 - HP Impact Survey Pilot Feedback_Final.docx Supplementary Document	2024-04-30
Attachment A12 - IRB Decision Letter.pdf Supplementary Document	2024-04-30
Attachment A11 - PMHCA FGD Flyer_Final.pdf Supplementary Document	2024-04-30
Attachment A10 - PMHCA FGD Overview Guide_Final.docx Supplementary Document	2024-04-30
Attachment A9 - PMHCA FGD Recruitment Procedures_Final.docx Supplementary Document	2024-04-30
Attachment A8 - PMHCA FGD Recruiter Email From JBS_Final.docx Supplementary Document	2024-04-30
Attachment A7 - PMHCA HP Survey Reminder Email From Program_Final.docx Supplementary Document	2024-04-30
Attachment A6 - PMHCA HP Survey Participation Email From Program_Final.docx Supplementary Document	2024-04-30
Attachment A5 - PMHCA HP Survey Reminder Email From JBS_Final.docx Supplementary Document	2024-04-30
Attachment A4 - PMHCA HP Survey Participation Email From JBS_Final.docx Supplementary Document	2024-04-30
Attachment A1 - Legislation_Final.docx Supplementary Document	2024-04-30
Attachment A2 - 60-day FRN Publication_Final.pdf Supplementary Document	2024-04-30
Supporting Statement B- MCHB- PMHCA- New- 04302024.docx Supporting Statement B	2024-04-30
Supporting Statement A- MCHB- PMHCA- New - OIRA- JBS- Clean 07182024.docx Supporting Statement A	2024-07-18

IC Document Collections

IC ID	Document Title	Status
267354	Health Professional Impact Survey Form and Instruction	Unchanged
267352	Family/Caregiver Focus Group Discussion Form and Instruction	Unchanged
267351	Family/Caregiver Demographic Questionnaire Form and Instruction	Modified