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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Comparison Group Clinic Director Coordination
New
10
80
0
Instruction
Extraction of Grantee Registry/EHR Data
New
660
5280
0
Form and Instruction
Electronic Data Collection Tool
Electronic Data Collection Tool
Focus Groups
New
240
240
0
Form and Instruction
Electronic Data Collection Tool
Electronic Data Collection Tool
Grantee - Site Visits
New
110
150
0
Form and Instruction
On-site Staff Interview Protocol
On-site Staff Interview Protocol
Grantee Director - Phone
New
60
60
0
Form and Instruction
Telephone Interview Protocol
Telephone Interview Protocol
Grantee Director - Web
New
149
75
0
Form and Instruction
Director Survey
Director Survey
Grantee Frontline Staff Survey
New
1494
747
0
Form and Instruction
Staff Survey
Staff Survey
SMI Clients
New
4250
4250
0
Form and Instruction
Client Health Assessment Questionnaire
Client Health Assessment Questionnaire
Total burden requested under this ICR:
6973
10882
0
To view an IC, click on IC Title