Client

SAMHSA 988 Suicide & Crisis Lifeline and Crisis Services Program Evaluation

Documents and Forms

Document Name Document Type
Form Client Experience Client Form and Instruction
Client Experience Client Experience Survey 988_Att H. Client Experience Survey_CES_03202025_Clean.docx Form and Instruction
Client Key Informa Client Key Informant Interview Direct Contact 988_Att I. Client Key Informant Interview Direct Contact_CKII_03202025_Clean.docx Form and Instruction
Client Key Informa Client Key Informant Interview Third Party Contact 988_Att J. Client Key Informant Interview Third Party Contact_C-KII_03202025_Clean.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Client	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Client Experience Survey	Client Experience Survey	988_Att H. Client Experience Survey_CES_03202025_Clean.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Client Key Informant Interview Direct Contact	Client Key Informant Interview Direct Contact	988_Att I. Client Key Informant Interview Direct Contact_CKII_03202025_Clean.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Client Key Informant Interview Third Party Contact	Client Key Informant Interview Third Party Contact	988_Att J. Client Key Informant Interview Third Party Contact_C-KII_03202025_Clean.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Client	FR Citation: 74 FR 28264

Number of Respondents: 8,009	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	48,054	48,054
Annual IC Time Burden (Hours)	37,482	37,482
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.