Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Enrollee Survey Round 1 (nonrespondents) New 468 23 0 Other-ENROLLEE SURVEY INSTRUMENTS (Round 1).
Other-ENROLLEE SURVEY INSTRUMENTS (Round 1)
Enrollee Survey Round 2 (Nonrespondents) New 1404 70 0 Other-Enrollee Survey Instruments (Round 2)
Other-Enrollee Survey Mailings (Round 2)
Follow-up interviews with service users (Nonrespondents) New 30 3 0 Other-Interview topics for RETAIN enrollee
Follow-up interviews with service users (Respondents) New 20 53 0 Other-Follow-up interviews with service users (respondents)
RETAIN Enrollee Surveys Round 1 (respondents) Modified 1872 1217 0 Other-RETAIN ENROLLEE SURVEY INSTRUMENTS (R1, R2)
Other-RETAIN ENROLLEE SURVEY MAILINGS (Round 1)
RETAIN Enrollee Surveys Round 2 (respondents) New 5616 4212 0 Other-ENROLLEE SURVEY INSTRUMENTS (Round 2)
Other-ENROLLEE SURVEY MAILINGS (Round 2)
RETAIN Provider Surveys (R1 & R2) Removed 0 0 0 Other-RETAIN PROVIDER SURVEY INSTRUMENTS (R1, R2)
Other-RETAIN PROVIDER SURVEY MAILINGS (R1, R2)
Other-Finalized Survey Questions C15-C18
RETAIN Service Users Interview Removed 0 0 0 Other-RETAIN Service Users Interview Topics
RETAIN Staff Activity Logs Removed 0 0 0 Other-RETAIN Staff Activity Logs
RETAIN Staff Interviews Removed 0 0 0 Other-RETAIN Staff Interview Topics
Total burden requested under this ICR: 9410 5578 0  
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