OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Primary and Behavioral Health Care Integration Evaluation

OMB 0930-0365 · HHS/SAMHSA.

OMB 0930-0365

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form Client Health Asse SMI ClientsForm and Instruction
Form Electronic Data Co Extraction of Grantee Registry/EHR DataForm and Instruction
Form Electronic Data Co Focus GroupsForm and Instruction
Form On-site Staff Inte Grantee - Site VisitsForm and Instruction
Form Telephone Intervie Grantee Director - PhoneForm and Instruction
Form Staff Survey Grantee Frontline Staff SurveyForm and Instruction
Form Director Survey Grantee Director - WebForm and Instruction
OMB_Part B Final PBHCI 6 24 2016.docxSupporting Statement B
OMB_Part A FINAL PBHCI 6 24 2016.docxSupporting Statement A
Comparison Group Clinic Director Coordination Instruction
SMI Clients Form and Instruction
Extraction of Grantee Registry/EHR Data Form and Instruction
Focus Groups Form and Instruction
Grantee - Site Visits Form and Instruction
Grantee Director - Phone Form and Instruction
Grantee Frontline Staff Survey Form and Instruction
Grantee Director - Web Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201605-0930-003 New collection (Request for a new OMB Control Number) 2016-06-29 Approved without change