Pre-Training Survey

Evaluation of the Mental Health First Aid Program

Documents and Forms

Document Name Document Type
Form Pre-Training Surve Pre-Training Survey Form and Instruction
Pre-Training Surve Pre-Training Survey 1__Attachment 1 - MHFA pre training survey.pdf Form and Instruction
5__Attachment 5 - MHFA Evaluation consent form for pre-training survey 02 24 16.pdf Pre-Training Consent Form IC Document

Information Collection (IC) Details

IC Title:	Pre-Training Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Pre-Training Survey	Pre-Training Survey	1__Attachment 1 - MHFA pre training survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 22,800	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	22,800	22,800
Annual IC Time Burden (Hours)	7,524	7,524
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Pre-Training Consent Form	5__Attachment 5 - MHFA Evaluation consent form for pre-training survey 02 24 16.pdf	07/26/2016

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