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 can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
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 Youth Form and Instruction
Form TSA-6-12 TSA-6-12 Form and Instruction
Form TSA-P TSA-P Form and Instruction
Form TSA Consent to Con TSA Consent to Contact Form and Instruction
Form Prevention Strateg Prevention Strategies Inventory (PSI) (document unavailable) Form and Instruction
Form EIRFT-Screening Fo EIRFT-Screening Form Form and Instruction
Form EIRFT-Individual F EIRFT-Individual Form Form and Instruction
Form Training Activity Training Activity Summary Page (TASP) Form and Instruction
Form Prevention Strateg Project Evaluators Form and Instruction
0930-0286 No Material or Nonsubstantive Change-GLS Evaluation - OMB.docx (document unavailable) Justification for No Material/Nonsubstantive Change
0930-0286 No Material or Nonsubstantive Change-GLS Evaluation.docx Justification for No Material/Nonsubstantive Change
Att K. SPDC DUA 7_24_23 final.docx Supplementary Document
Att A. GLS Memorial Act 7_24_23 final.docx Supplementary Document
GLS Evaluation Part B 7-24_23 final.docx Supporting Statement B
GLS Evaluation Part A 7_24_23 final.docx Supporting 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

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

OMB Details

Project Evaluators

Federal Enterprise Architecture: Health - Public Health Monitoring

Form Training Activity Summary Page (TASP)	Training Activity Summary Page (TASP)	Fillable Fileable	Form and instruction
Form Prevention Strategies Inventory (PSI)	Prevention Strategies Inventory (PSI)	Fillable Fileable	Form and instruction
Form EIRFT-Screening Form	EIRFT-Screening Form	Fillable Fileable	Form and instruction
Form EIRFT-Individual Form	EIRFT-Individual Form	Fillable Fileable	Form and instruction

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