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Session Report Form
Participant Feedback Forms for the Mental Health Care Provider Education (MHCPE) in the HIV/AIDS Program
OMB: 0930-0195
IC ID: 7583
OMB.report
HHS/SAMHSA
OMB 0930-0195
ICR 201705-0930-003
IC 7583
( )
Documents and Forms
Document Name
Document Type
Form All IC Forms
Session Report Form
Form and Instruction
All IC Forms All IC Forms
Attachment A_Instructions&Forms.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Session Report Form
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
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
All IC Forms
All IC Forms
Attachment A_Instructions&Forms.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
600
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 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
600
0
0
0
0
600
Annual IC Time Burden (Hours)
48
0
0
0
0
48
Annual IC Cost Burden (Dollars)
0
0
0
0
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.