BHIT Survey

Behavioral Health Information Technologies Survey

OMB: 0930-0352

IC ID: 216733

Information Collection (IC) Details

View Information Collection (IC)

BHIT Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction BHITS BHITS Attachment 1_Survey Questions_05_28_15.docx Yes Yes Fillable Fileable

Health Health Care Services

 

374 0
   
State, Local, and Tribal Governments
 
   100 %

  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 374 0 374 0 0 0
Annual IC Time Burden (Hours) 150 0 150 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Data Dictionary Attachment 2_Data Dictionary-Key-Terms-Definitions_2_27_15.docx 05/28/2015
Survey Question Crosswalk Attachment 3_Survey Question Crosswalk to Research Question and Domain_052215.docx 05/28/2015
Pilot_Protocol Attachment 4_Pilot_Protocol_Schedule_Documents-2_27_15.docx 05/28/2015
Grantee Letter Attachment 5_GranteeLetter_2_27_15.doc 05/28/2015
Screnn Shots Attachment 6_ScrennShots._5_27_15pdf 05/28/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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