OMB control number
Screening, Brief Intervention, and Referral to Treatment (SBIRT) Cross-Site Evaluation
OMB 0930-0321 · HHS/SAMHSA.
OMB 0930-0321
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form Practitioner Surve Practitioner Survey | Form and Instruction |
| 2 SBIRT II OMB Supporting Statement 2011-03-03.doc | Supporting Statement B |
| Attachment 6 Table Shell Descriptive Results.doc | Supplementary Document |
| Attachment 5 Practitioner Informed Consent.doc | Supplementary Document |
| Attachment 4 Privacy Pledge.doc | Supplementary Document |
| Attachment 3 Network Security at RTI.doc | Supplementary Document |
| Attachment 1 Evaluation Questions.doc | Supplementary Document |
| 2 SBIRT II OMB Supporting Statement 2011-03-03.doc | Supporting Statement A |
 Practitioner Survey |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201012-0930-003 | New collection (Request for a new OMB Control Number) | 2010-12-30 | Approved with change |