Organizational Staff/ Crisis Agency Manager

SAMHSA 988 Suicide & Crisis Lifeline and Crisis Services Program Evaluation

Documents and Forms

Document Name Document Type
Form Crisis Continuum P Organizational Staff/ Crisis Agency Manager Form and Instruction
Crisis Continuum P Crisis Continuum Provider Survey 988_Att C. Crisis Continuum Provider Survey_CCPS_03202025_Clean.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Organizational Staff/ Crisis Agency Manager	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	Crisis Continuum Provider Survey	Crisis Continuum Provider Survey	988_Att C. Crisis Continuum Provider Survey_CCPS_03202025_Clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Organizational Staff/ Crisis Agency Manager	FR Citation: 75 FR 28264

Number of Respondents: 1,034	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,034	1,034
Annual IC Time Burden (Hours)	1,551	1,551
Annual IC Cost Burden (Dollars)	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.