Webinar Feedback Form Follow-up Interviews

SAMHSA Disaster Technical Assistance Center Training, Webinar, Podcast, and Mobile Application Feedback Forms

Documents and Forms

Document Name Document Type
Form Webinar Follow-Up Webinar Feedback Form Follow-up Interviews Form and Instruction
Webinar Follow-Up Webinar Follow-Up Interview NB Attachment B2 Webinar Follow-Up Interview 7.25.2013.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Webinar Feedback Form Follow-up Interviews	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Webinar Follow-Up Interview	Webinar Follow-Up Interview	NB Attachment B2 Webinar Follow-Up Interview 7.25.2013.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 195	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	195	195
Annual IC Time Burden (Hours)	98	98
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.