View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

National Training and Technical Assistance Center for Early Serious Mental Illness
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Individualized TA Request Form Individualized Technical Assistance (TA) Request Form 0930-0393 Fast Track Generic_ESMI TTA Center_Att A_Individualized TA Request Form.docx Yes Yes Fillable Fileable
Form and Instruction Individualized TA Satisfaction Form Individualized Technical Assistance (TA) Satisfaction Form 0930-0393 Fast Track Generic_ESMI TTA Center_Att B_Individualized TA Satisfaction Form.docx Yes Yes Fillable Fileable
Form and Instruction TTA Individual Session Feedback Form TTA Individual Session Feedback Form 0930-0393 Fast Track Generic_ESMI TTA Center_Att C_LC Individual Session Feedback Form.docx Yes Yes Fillable Fileable
Form and Instruction Overall Series Feedback Form Overall Series Feedback Form 0930-0393 Fast Track Generic_ESMI TTA Center_Att D_LC Overall Series Feedback Form.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

Privacy Act of 1974 (Title 5 United States Code [U.S.C.] 552a)   75 FR 28264

130 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 375 0 375 0 0 0
Annual IC Time Burden (Hours) 46 0 46 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Early Serious Mental Illness Request Template 0930-0393 Fast Track Generic_ESMI TTA Center.docx 07/01/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.