Grantee/Healthcare Organization Administrator

Zero Suicide Evaluation

OMB:

IC ID: 272540

Information Collection (IC) Details

View Information Collection (IC)

Grantee/Healthcare Organization Administrator
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Behavioral Health Provider Survey Behavioral Health Provider Survey Att C. Behavioral Health Provider Survey_OMB_clean.docx Yes Yes Fillable Fileable
Form and Instruction Key Informant Interview Case Study Key Informant Interview Case Study Att D. Key Informant Interview Guide_OMB_clean.docx Yes Yes Fillable Fileable
Form and Instruction Key Informant Interview Cost Study Key Informant Interview Cost Study Att E_A. Key Informant Interview Guide-Cost_Sub_Study_OMB_clean.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

GLS National Outcomes Evaluation Suicide Prevention Data Center  75 FR 28264

56 0
   
State, Local, and Tribal Governments
 
   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 168 0 168 0 0 0
Annual IC Time Burden (Hours) 99 0 99 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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