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

View Information Collection (IC)

988 Suicide & Crisis Lifeline Customer Feedback
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CT IDI Screener CT IDI Screener 988 CT IDI Screener FINAL 11-22.docx Yes Yes Fillable Fileable
Form and Instruction CT Survey AQ CT Survey AQ 988 CT Survey AQ FINAL 11-22.docx Yes Yes Fillable Fileable
Form and Instruction CT IDI Check-in CT IDI Check-In 988 CT IDI Check_In_D-HH FM FINAL 11-19.docx Yes Yes Fillable Fileable
Form and Instruction CT IDI Discussion Guide CT IDI Discussion Guide 988 CT IDI Discussion Guide FINAL 11-19.docx Yes Yes Fillable Fileable
Form and Instruction CT Survey Screener CT Survey Screener 988 CT Survey SCREENER D-HH FINAL 11-22.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

995 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 995 0 995 0 0 0
Annual IC Time Burden (Hours) 370 0 370 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Creative Addendum 988 Creative Addendum FINAL 11-19.docx 12/03/2024
CT IDI Consent Form 988 CT IDI Consent Form FINAL 11-22.docx 12/03/2024
CT Survey Assent Form 988 CT Survey ASSENT FORM FINAL 11-22.docx 12/03/2024
CT Survey Parent Consent 988 CT Survey PARENT CONSENT FINAL 11-22.docx 12/03/2024
Template Request Template Request.docx 12/03/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.