Consumer

Zero Suicide Evaluation

OMB: 0930-0401

IC ID: 272538

Information Collection (IC) Details

View Information Collection (IC)

Consumer
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Consumer Study Interest Form Consumer Study Interest Form Att K. Consumer Study Interest Form.docx Yes Yes Fillable Fileable
Form and Instruction Consumer Key Informant Interview Consumer Key Informant Interview Att L. Consumer KII.docx Yes Yes Fillable Fileable
Form and Instruction Consumer Experience Survey Consumer Experience Survey Att J. Consumer Experience Survey.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

GLS National Outcomes Evaluation Suicide Prevention Data Center  75 FR 28264

1,986 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 5,958 0 0 0 0 5,958
Annual IC Time Burden (Hours) 2,383 0 0 0 0 2,383
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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