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SSG Fox SPGP - Columbia Suicide Risk Screening (CSSRS)
Staff Sergeant Parker Gordon Fox - Suicide Prevention Grant Program (SSG Fox SPGP)
OMB: 2900-0904
IC ID: 253145
OMB.report
VA
OMB 2900-0904
ICR 202210-2900-015
IC 253145
( )
Documents and Forms
Document Name
Document Type
Columbia Suicide Severity Rating Scale_CSSRS_SSG Fox SPGP.pdf
Other-Screening Tool
Columbia Suicide Severity Rating Scale_CSSRS_SSG Fox SPGP.pdf
Other-Screening Tool
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
SSG Fox SPGP - Columbia Suicide Risk Screening (CSSRS)
Agency IC Tracking Number:
2900-0904
Is this a Common Form?
No
IC Status:
Modified
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
Other-Screening Tool
Columbia Suicide Severity Rating Scale_CSSRS_SSG Fox SPGP.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
90
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
6,030
0
0
0
0
6,030
Annual IC Time Burden (Hours)
1,508
0
0
0
0
1,508
Annual IC Cost Burden (Dollars)
0
0
0
0
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.