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Strategic Prevention Technical Assistance Center (Updated)
 
New
 
Voluntary
 
5 CFR 1320.8(d)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Protocol for Immediate Post Event Feedback Survey Protocol for Immediate Post Event Feedback Survey SPTAC Appendix 1 Protocol for Immediate Post Event Feedback Survey-CLEAN.docx Yes Yes Fillable Fileable
Form and Instruction Protocol for 60-Day Follow Up Survey for Events Protocol for 60-Day Follow Up Survey for Events SPTAC Appendix 2 Protocol for 60-Day Follow Up Survey for EventsTraining CLEAN.docx Yes Yes Fillable Fileable
Form and Instruction Protocol for 60Day Follow-Up Survey Technical Asst Protocol for 60-Day Follow Up Survey for Events SPTAC Appendix 3 Protocol for 60-Day Follow Up Survey for Technical Assistance CLEAN.docx Yes Yes Fillable Fileable
Form and Instruction Cumulative Services Assessment for STT Cumulative Services Assessment for STT SPTAC Appendix 4 Cumulative Services Assessment for States Tribes and Territories CLEAN.docx Yes Yes Fillable Fileable
Form and Instruction Cumulative Services Assessment for CFS Cumulative Services Assessment for CFS SPTAC Appendix 5 Cumulative Services Assessment for CFS CLEAN.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

1 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 1 0 1 0 0 0
Annual IC Time Burden (Hours) 1 0 1 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request Template SPTAC 0930 SAMHSA Research and Assessment Generic Request Template.docx 05/22/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.