Information Collection

Program Implementation Semi-Structured Interview (SSI)

IC 271506 under ICR 202505-0906-005 · OMB 0906-0105.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1O Program Implementation Semi-Structured Interview (SSI)	Form and Instruction
Form 1O Attachment 1O - Program Implementation SSI PMHCA Program Implementation Semi-Structured Interview (SSI)	Form and Instruction
Form 1G Attachment 1G - Program Implementation SSI MMHSUD Program Implementation Semi-Structured Interview (SSI)	Form and Instruction
Form 1G 1G_MCHB_0906-0105_MMHSUD Program Implementation SSI_Redline Program Implementation Semi-Structured Interview (SSI)	Form and Instruction
Form 1O 1O_MCHB_0906-0105_MCHB_PMHCA Program Implementation SSI_Redline Program Implementation Semi-Structured Interview (SSI)	Form and Instruction
1O Attachment 1O - Program Implementation SSI PMHCA Attachment B4 - Program Implementation SSI, V3, 2021-2023 PMHCA_NON-APPROVED_OMB.docx	Form and Instruction
1O Attachment 1O - Program Implementation SSI PMHCA Attachment B4 - Program Implementation SSI, V3, 2021-2023 PMHCA_NON-APPROVED_OMB.docx	Form and Instruction
1G Attachment 1G - Program Implementation SSI MMHSUD Attachment B12 - Program Implementation SSI, V2, 2023 MMHSUD_NON-APPROVED_OMB.docx	Form and Instruction
1G Attachment 1G - Program Implementation SSI MMHSUD Attachment B12 - Program Implementation SSI, V2, 2023 MMHSUD_NON-APPROVED_OMB.docx	Form and Instruction
1G 1G_MCHB_0906-0105_MMHSUD Program Implementation SSI_Redl 1G_MCHB_0906-0105_MMHSUD Program Implementation SSI_Redline.docx	Form and Instruction
1G 1G_MCHB_0906-0105_MMHSUD Program Implementation SSI_Redl 1G_MCHB_0906-0105_MMHSUD Program Implementation SSI_Redline.docx	Form and Instruction
1O 1O_MCHB_0906-0105_MCHB_PMHCA Program Implementation SSI_ 1O_MCHB_0906-0105_MCHB_PMHCA Program Implementation SSI_Redline.docx	Form and Instruction
1O 1O_MCHB_0906-0105_MCHB_PMHCA Program Implementation SSI_ 1O_MCHB_0906-0105_MCHB_PMHCA Program Implementation SSI_Redline.docx	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Program Implementation Semi-Structured Interview (SSI)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1O	Yes	Yes	Fillable Fileable
Form and Instruction	1G	Yes	Yes	Fillable Fileable
Form and Instruction	1G	Yes	Yes	Fillable Fileable
Form and Instruction	1O	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 134

Number of Respondents for Small Entity: 134

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	134	134
Annual IC Time Burden (Hours)	134	134
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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