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Evaluation of SAMHSA Primary Care Behavioral Health Integration Grant Program
OMB 0990-0371
OMB.report
HHS/HHSDM
OMB 0990-0371
OMB 0990-0371
Latest Forms, Documents, and Supporting Material
Document
Name
OMB Supporting Statment Part B 9 23 11_V3.docx
Supporting Statement B
OMB Supporting Statement Part A Full Pkg 9 23 11_V4.docx
Supporting Statement A
Grantee Key Staff- Web Survey
Other-survey
SMI Clients- Clients Exam and Survey-Follow-up
Other-form
Grantee Project Directors- Quarterly Reports
Other-form
Grantee Data - Individual Service Utilization Data
Other-survey
Grantee Data Staff -TRAC Indicators
Other-surve
Control Site leadership - Site visit Interview
Other-survey
Care coordinators interivew
Other-survey
MH Provider Interview
Other-survey
Grantee PH Providers- Site Visit Interview
Other-survey
Grantee Leadership (Sites Visit Interview)
Other-interview
SMI Clients -Client Exam and Survey-Baseline
Other-survey
All Historical Document Collections
201107-0990-004
Approved with change
Revision of a currently approved collection
2011-07-27
201102-0990-002
Approved with change
New collection (Request for a new OMB Control Number)
2011-02-04
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