N-SUMHSS Client Counts Worksheet final

N SUMHSS
NATIONAL SUBSTANCE USE AND MENTAL HEALTH SERVICES SURVEY

Client Counts Worksheet
202X National Substance Use and Mental Health Services Survey (N-SUMHSS)

Important instructions for the N-SUMHSS 202X
Located with this instructions page is a worksheet consisting of questions D4 through D15 from the 202X
N-SUMHSS. These questions contain several important components of information that will be collected during
your completion of the client counts section of the survey. To preview the client counts section for wording and
specifics of who to count, please visit https://info.nsumhss.samhsa.gov and click on the questionnaire.
To save time, and to complete the online survey more efficiently, you may wish to gather this information prior
to beginning the survey. If you do collect this information ahead of time, please be sure to keep this sheet
accessible for when you complete the online survey. Although this is not a necessary step to completing the
survey, it may ease your survey completion process. Please keep the following points in mind when completing
this worksheet.
• This worksheet is a tool to help you respond to the survey. Please transfer all information from your
client counts worksheet into the corresponding questions of the web survey. Do not return this
worksheet to ICF.
• Questions D4 through D15 on the N-SUMHSS ask about the number of clients in treatment on
March XX, 202X If possible, report clients for this facility only.
• If you have multiple facilities in your network/organization, please write your "Facility/Group name
and Facility User ID" in the space provided at the top of the worksheet to keep track of each of your
facility's client counts. It might be helpful to make a copy of this worksheet for each facility/group.
• You may use estimated information to indicate your client counts if necessary.
•

Please refer to the enclosed blue flyer in your survey packet or to your invitation email to obtain
your facility's web survey login information.

If you have additional questions, you can reach out to ICF at (833) 302-1759 or ICFsupport@nsumhss.org.

1

March XX, 202X

March XX, 202X

March XX, 202X

March XX, 202X
March XX, 202X

March XX, 202X

March XX, 2023

March XX, 202X

March XX, 202X

March XX, 202X
March XX, 202X

March XX, 202X

April XX, 202X