OMB
.report
Search
Participant Feedback Form
Advancing Wellness and Resilience in Education and Trauma-Informed Services in Schools
OMB: 0930-0398
IC ID: 266676
OMB.report
HHS/SAMHSA
OMB 0930-0398
ICR 202404-0930-003
IC 266676
( )
Documents and Forms
Document Name
Document Type
Form Participant Feedba
Participant Feedback Form
Form and Instruction
Participant Feedba Participant Feedback Form
Att.F_PFF for OMB_CLEAN_10242023.docx
Form and Instruction
Participant Feedba Participant Feedback Form
Att.F_PFF for OMB_CLEAN_10242023.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Participant Feedback Form
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
Participant Feedback Form
Participant Feedback Form
Att.F_PFF for OMB_CLEAN_10242023.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Privacy Act of 1974 (Title 5 United States Code [U.S.C.] 552a)
FR Citation:
75 FR 28264
Number of Respondents:
2,775
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 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
2,775
0
2,775
0
0
0
Annual IC Time Burden (Hours)
416
0
416
0
0
0
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.