View Information Collection (IC)
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N-SUMHSS (either SU or MH)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction N-SUMHSS 2021 Questionnaire N-SUMHSS 2021 Questionnaire Attachment B1_N-SUMHSS 2021 Questionnaire 060320.docx Yes Yes Fillable Fileable
Form and Instruction N-SUMHSS 2021 Web Survey Prototype N-SUMHSS 2021 Web Survey Prototype Attachment B3_N-SUMHSS 2021 Web Survey Prototype 072320.docx Yes Yes Fillable Fileable
Form and Instruction N-SUMHSS 2021 CATI Questionnaire N-SUMHSS 2021 CATI Questionnaire Attachment B4_N-SUMHSS 2021 CATI Questionnaire 061220.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

32,000 0
   
State, Local, and Tribal Governments
 
   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 32,000 0 32,000 0 0 0
Annual IC Time Burden (Hours) 21,440 0 21,440 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
N-SUMHSS 2021 Advance Letter Attachment B5_N-SUMHSS 2021 Advance Letter v051920.docx 08/20/2020
N-SUMHSS 2021 Cover Letter_Web Access Instructions_FAQs Attachment B6_N-SUMHSS 2021 Cover Letter_Web Access Instructions_FAQs_061020.pdf 08/20/2020
N-SUMHSS 2021 Thank You Reminder Letter Attachment B7_N-SUMHSS 2021 Thank You Reminder Letter v052020.docx 08/20/2020
N-SUMHSS 2021 Completion Thank You Letter Attachment B10_N-SUMHSS 2021 Completion Thank You Letter v061220.DOCX 08/20/2020
N-SUMHSS 2021 Second Mailing Cover Letter Attachment B8_N-SUMHSS 2021 Second Mailing Cover Letter v052020.docx 08/20/2020
N-SUMHSS 2021 Third Mailing Cover Letter Attachment B9_N-SUMHSS 2021 Third Mailing Cover Letter v061220.DOCX 08/20/2020
Prototype of 2021 N-SUMHSS Information Website Attachment B12_Prototype of 2021 N-SUMHSS Information Website.docx 08/20/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.