OMB control number

Cross-Site Evaluation of the National Child Traumatic Stress Initiative (NCTSI)

OMB 0930-0276 · HHS/SAMHSA.

OMB 0930-0276

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form Baseline Core Clinical Characteristics Forms-Baseline and Follow-up	Form and Instruction
Form Sustainability Sur Sustainability Survey Affiliate Centers	Form and Instruction
Form National Reach Sur National Research Survey	Form and Instruction
Form Training Sign-in S Training Sign-in Sheet	Form and Instruction
Form ETSC_Providers EBP/ETSC Provider	Form and Instruction
Form Training Summary F Training Summary Form	Form and Instruction
Form EBP/ETSC EBP/ETSC Administrator	Form and Instruction
Form Sustainability_Fun Sustainability Survey for Currently Funded Centers	Form and Instruction
Form OPMR Online Performance Monitoring Report	Form and Instruction
Form GAIN-MSS Global Appraisal of Individual Needs Modified Shore Screener	Form and Instruction
Form CDI-2S Children Depression Inventory	Form and Instruction
Form TSCC_A Trauma Symptoms Checklist for Children Abbreviated	Form and Instruction
Form PSI Short Form Parenting Stress Index	Form and Instruction
Form TSCYC Trauma Symptoms Checklist for Young Children	Form and Instruction
Form UCLA PTSD USLA-PTSD Short Form	Form and Instruction
Form CBCL 1.5 to 5 Core Clinical Characteristics Form	Form and Instruction
Form Detail Form Trauma Information /Detail Form	Form and Instruction
Core Data Set Youth Assent middle school_12-09-11.docx	Supplementary Document
Core Data Set Youth Assent elemen school_12-09-11.docx	Supplementary Document
Core Data Set Caregiver Consent_12-09-11.doc	Supplementary Document
NCTSI SS 9.7.11-B.doc	Supporting Statement B
Attachment A_B.pdf	Supplementary Document
Attachment J_O.pdf	Supplementary Document
NCTSI SS 9-6-11_rev 12-9-11.doc	Supporting Statement A
Core Clinical Characteristics Forms-Baseline and Follow-up	Form and Instruction
Sustainability Survey Affiliate Centers	Form and Instruction
National Research Survey	Form and Instruction
Training Sign-in Sheet	Form and Instruction
EBP/ETSC Provider	Form and Instruction
Training Summary Form	Form and Instruction
EBP/ETSC Administrator	Form and Instruction
Sustainability Survey for Currently Funded Centers	Form and Instruction
Online Performance Monitoring Report	Form and Instruction
Global Appraisal of Individual Needs Modified Shore Screener	Form and Instruction
Children Depression Inventory	Form and Instruction
Trauma Symptoms Checklist for Children Abbreviated	Form and Instruction
Parenting Stress Index	Form and Instruction
Trauma Symptoms Checklist for Young Children	Form and Instruction
USLA-PTSD Short Form	Form and Instruction
Core Clinical Characteristics Form	Form and Instruction
Trauma Information /Detail Form	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
201109-0930-005	Revision of a currently approved collection	2011-09-27	Approved with change
200903-0930-002	Revision of a currently approved collection	2009-03-26	Approved without change
200709-0930-002	No material or nonsubstantive change to a currently approved collection	2007-09-05	Approved without change
200601-0930-001	New collection (Request for a new OMB Control Number)	2006-01-18	Approved without change