OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Mental Health Surveys

IC 265929 under ICR 202402-1405-001 · OMB 1405-0193.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Mental Health Surveys
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Survey Mental Health Surveys 1. Questions 1 & 2.pdf Yes Yes Fillable Fileable
Form and Instruction Survey Mental Health Surveys 2. Question 3.pdf Yes Yes Fillable Fileable
Form and Instruction Survey Mental Health Surveys 3. Question 4 - Question about RMOP Service.pdf Yes Yes Fillable Fileable
Form and Instruction Survey Mental Health Surveys 4. Question 5 & 6 (9 questions total) - Questions about RMOP Service - Counseling and_or Therapy.pdf Yes Yes Fillable Fileable

Workforce Management Training and Employment

Mental Health Surveys  89 FR 12316

14,000 0
   
Individuals or Households
 
   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 14,000 0 14,000 0 0 0
Annual IC Time Burden (Hours) 3 0 3 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
DS-4183 ds4183 - MH survey (signed).pdf 03/12/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.