ACF Behavioral Health Survey

Formative Data Collections for ACF Program Support

OMB: 0970-0531

IC ID: 258666

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

View Information Collection (IC)

ACF Behavioral Health Survey
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Behavioral Health Survey - English - 1.23.23.docx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

500 0
   
Individuals or Households
 
   100 %

  Requested 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 500 0 0 0 0 500
Annual IC Time Burden (Hours) 73 0 0 0 0 73
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A SSA Template - Formative for ACF Program Support - BH survey - clean final draft 1.19.23.docx 02/22/2023
Supporting Statement B SSB Template - Formative for ACF Program Support- BH survey - clean final draft 1.19.23.docx 02/22/2023
Survey Spanish Version Behavioral Health Survey - Spanish - 1.24.23.docx 02/22/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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