Clinical Parent Interview

National Mental Health Study (NMHS) Field Test

Documents and Forms

Document Name Document Type
Form CRS Parent Questio Clinical Parent Interview Form and Instruction
CRS Parent Questio CRS Parent Questionnaire NMHS OMB_PDF 05.pdf Form and Instruction
NMHS OMB_PDF 12.pdf CRS Parent Materials IC Document

Information Collection (IC) Details

IC Title:	Clinical Parent Interview	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	CRS Parent Questionnaire	CRS Parent Questionnaire	NMHS OMB_PDF 05.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
CRS Parent Materials	NMHS OMB_PDF 12.pdf	07/10/2017

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