Retention of Behavior Health Providers Survey

Retention of Behavior Health Providers Survey

OMB: 0720-0043

IC ID: 192473

Documents and Forms
Document Name
Document Type
Other-Supplemental Information
Other-Survey
Information Collection (IC) Details

View Information Collection (IC)

Retention of Behavior Health Providers Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Supplemental Information Letters-Reminders-Phone Script.pdf.pdf No   Paper Only
Other-Survey Survey Former Providers.docx Yes Yes Fillable Fileable

Defense and National Security Operational Defense

 

164 0
   
Individuals or Households
 
   50 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 164 0 164 0 0 0
Annual IC Time Burden (Hours) 41 0 41 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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