Providers Trainees

Garrett Lee Smith (GLS) State/Tribal Youth Suicide Prevention and Early Intervention Evaluation

Documents and Forms

Document Name Document Type
Form TSA Consent to Con Providers Trainees Form and Instruction
TSA Consent to Con TSA Consent to Contact Att F.TSA.docx Form and Instruction
TSA-P TSA-P Att D.TSA.docx Form and Instruction
TSA-6-12 TSA-6-12 Att E. TSA-6_12_for OMB 7_24_23 final.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Providers Trainees	Agency IC Tracking Number:

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TSA Consent to Contact	TSA Consent to Contact	Att F.TSA.docx	Yes	Yes	Fillable Fileable
Form and Instruction	TSA-P	TSA-P	Att D.TSA.docx	Yes	Yes	Fillable Fileable
Form and Instruction	TSA-6-12	TSA-6-12	Att E. TSA-6_12_for OMB 7_24_23 final.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,428	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	20,428	20,428
Annual IC Time Burden (Hours)	3,974	3,974
Annual IC Cost Burden (Dollars)	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.