View Information Collection (IC)

View Information Collection (IC)

IC Title:	Post Behavioral Health Data Users Conference Satisfaction Survey	Agency IC Tracking Number:

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	Data Users Satisfaction Survey	Data Users Satisfaction Survey	Attachment 1 (Post Behavioral Health Data Users Conference Satisfaction Survey).docx		Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	200	0	200	0	0	0
Annual IC Time Burden (Hours)	40	0	40	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Justification	SAMHSA Customer Satisfaction Survey (Post Behavioral Health Data Users Conference Satisfaction Survey).docx	08/21/2012
Letter	Trans.Let-6-2012.doc	08/21/2012

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