Client Focus Groups

Evaluation of the Extension of the Certified Community Behavioral Health Clinic (CCBHC) Demonstration Program

Documents and Forms

Document Name Document Type
Attachment E. CCBHC Client Focus Group Protocol.docx Other-Focus Group Protocol
Attachment E. CCBHC Client Focus Group Protocol.docx Other-Focus Group Protocol
Attachment F. CCBHC Client Focus Group Consent Form.docx Client Focus Group Consent IC Document
Attachment F. CCBHC Client Focus Group Consent Form.docx Client Focus Group Consent IC Document

Information Collection (IC) Details

IC Title:	Client Focus Groups	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
Other-Focus Group Protocol			Attachment E. CCBHC Client Focus Group Protocol.docx		No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	14	14
Annual IC Time Burden (Hours)	14	14
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Client Focus Group Consent	Attachment F. CCBHC Client Focus Group Consent Form.docx	08/25/2022

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