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Federal forms, ICRs, and supporting documents

OMB control number

Garrett Lee Smith (GLS) State/Tribal Youth Suicide Prevention and Early Intervention Evaluation

OMB 0930-0286 · HHS/SAMHSA.

OMB 0930-0286

The information collected through the four stages of the cross-site evaluation of the GLS Suicide Prevention and Early Intervention Programs will describe for State/Tribal grantees (1) the context in which suicide prevention activities are being implemented, (2) the products and services funded through the program, (3) the training experiences of individuals who receive training as part of the suicide prevention programs, (4) the utilization and penetration of the skills, knowledge and techniques learned through suicide prevention training programs, and (5) the referral networks in place to support youth identified at risk for suicide.

The latest form for Garrett Lee Smith (GLS) State/Tribal Youth Suicide Prevention and Early Intervention Evaluation expires 2027-01-31 and is listed under ICR 202509-0930-013.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form Youth Experience R Youth Experience Reflective Journal (YERJ)Form and Instruction
Form Youth Outcomes and Youth Outcomes and Resiliency Survey (YORS)Form and Instruction
Form Youth Outcomes and YouthForm and Instruction
Form TSA-6-12 TSA-6-12Form and Instruction
Form TSA-P TSA-PForm and Instruction
Form TSA Consent to Con TSA Consent to ContactForm and Instruction
Form TSA Consent to Con Providers TraineesForm and Instruction
Form Prevention Strateg Prevention Strategies Inventory (PSI) (document unavailable)Form and Instruction
Form EIRFT-Screening Fo EIRFT-Screening FormForm and Instruction
Form EIRFT-Individual F EIRFT-Individual FormForm and Instruction
Form Training Activity Training Activity Summary Page (TASP)Form and Instruction
Form Prevention Strateg Project EvaluatorsForm and Instruction
0930-0286 No Material or Nonsubstantive Change-GLS Evaluation - OMB.docxJustification for No Material/Nonsubstantive Change
0930-0286 No Material or Nonsubstantive Change-GLS Evaluation.docxJustification for No Material/Nonsubstantive Change
Att K. SPDC DUA 7_24_23 final.docxSupplementary Document
Att K. SPDC DUA 7_24_23 final.docx Supplementary Document
Att A. GLS Memorial Act 7_24_23 final.docxSupplementary Document
Att A. GLS Memorial Act 7_24_23 final.docx Supplementary Document
GLS Evaluation Part B 7-24_23 final.docxSupporting Statement B
GLS Evaluation Part B 7-24_23 final.docxSupporting Statement B
GLS Evaluation Part A 7_24_23 final.docxSupporting Statement A
GLS Evaluation Part A 7_24_23 final.docxSupporting Statement A
Youth Form and Instruction
Youth Form and Instruction
Youth Form and Instruction
Providers Trainees Form and Instruction
Providers Trainees Form and Instruction
Providers Trainees Form and Instruction
Providers Trainees Form and Instruction
Project Evaluators Form and Instruction
Project Evaluators Form and Instruction
Project Evaluators Form and Instruction
Project Evaluators Form and Instruction
Project Evaluators Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202509-0930-013 No material or nonsubstantive change to a currently approved collection 2025-09-30
202311-0930-002 Reinstatement with change of a previously approved collection 2023-11-30 Approved without change
201512-0930-006 Revision of a currently approved collection 2015-12-28 Approved without change
201308-0930-001 Revision of a currently approved collection 2013-08-20 Approved with change
201006-0930-002 Revision of a currently approved collection 2010-06-08 Approved without change
200701-0930-005 New collection (Request for a new OMB Control Number) 2007-01-24 Approved with change

OMB Details

Project Evaluators

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form Training Activity Summary Page (TASP)Training Activity Summary Page (TASP)Fillable FileableForm and instruction
Form Prevention Strategies Inventory (PSI)Prevention Strategies Inventory (PSI)Fillable FileableForm and instruction
Form EIRFT-Screening FormEIRFT-Screening FormFillable FileableForm and instruction
Form EIRFT-Individual FormEIRFT-Individual FormFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.