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View Information Collection (IC)
View Information Collection (IC)
IC Title:
Pre & post-program survey questions for OMH Minority Leadership Development Program
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
Other-HHS Host-site pre-program questionnaire
HHS Host-Site Pre-Program Questionnaire_Clean.docx
Yes
Yes
Fillable Printable
Other-MLP Evaluation Scripts
MLP Evaluation Scripts_Clean.docx
No
Paper Only
Other-OMH Fellow Curriculum Post-Test Evaluations
OMH Fellow Curriculum Post-Test Evaluations_Clean.docx
Yes
Yes
Fillable Printable
Other-OMH Awardee Pre-Program Survey
OMH Awardee Pre-Program_Clean.docx
Yes
Yes
Fillable Printable
Other-OMH Fellow Curriculum Pre-Test Evaluations
OMH Fellow Curriculum Pre - Test Evaluations_Clean.docx
Yes
Yes
Fillable Printable
Other-OMH Fellow Pre-Program Questionnaire
OMH Fellow Pre-Program Questionaire_Clean.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
64
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
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
64
0
64
0
0
0
Annual IC Time Burden (Hours)
365
0
365
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Memo: Pre & post-program survey questions for OMH Minority Leadership Development Program
0990-0379 MEMO_FastTrack Generic_MLDP_624.docx
06/27/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.