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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Health Education Campaign Communication (HECC)
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
5 CFR 1320.8(d)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
HECC IDI GUIDE Current Use
HECC IDI GUIDE Current Use
SAMHSA_HECC_IDI_Guide_CurrentUse OMB REVISED 14MAR2024.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HECC IDI GUIDE In Treatment
HECC IDI GUIDE In Treatment
SAMHSA HECC_IDI_Guide_In Treatment OMB REVISED 14MAR2024.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HECC IDI Screener
HECC IDI Screener
SAMHSA HECC IDI Screener OMB REVISED 14MAR2024.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HECC Key Informant Health Workers Interview Guide
HECC Key Informant Health Workers Interview Guide
SAMHSA HECC_Key Informant health workers Interview Guide OMB REVISED 14MAR2024.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HECC Key Informant Close Contacts Interview Guide
HECC Key Informant Close Contacts Interview Guide
SAMHSA HECC_Key Informant close contacts Interview Guide OMB REVISED 14MAR2024.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Privacy Act of 1974 (Title 5 United States Code [U.S.C.] 552a)
FR Citation:
75 FR 28264
Number of Respondents:
180
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
180
0
180
0
0
0
Annual IC Time Burden (Hours)
108
0
108
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
HECC Template Request
0930-0397 HECC Request 2024-03-13_ REVISED 14MAR2024.docx
03/19/2024
HECC Support Protocol
SAMHSA HECC Support Protocol for Research Participants Approved FINAL.docx
03/19/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.