Parents/Caregivers

SAMHSA 988 Suicide & Crisis Lifeline and Crisis Services Program Evaluation

Documents and Forms

Document Name Document Type
Form Client Contact For Parents/Caregivers Form and Instruction
Client Contact For Client Contact Form Supplement for Parents 988_Att G. Client Contact Disposition Form Supplement for Parents_CCDF-PS_032025_Clean.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Parents/Caregivers	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	Client Contact Form Supplement for Parents	Client Contact Form Supplement for Parents	988_Att G. Client Contact Disposition Form Supplement for Parents_CCDF-PS_032025_Clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Parents/Caregivers	FR Citation: 74 FR 28264

Number of Respondents: 1,560	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,560	1,560
Annual IC Time Burden (Hours)	156	156
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.