View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	SAMHSA Continuing Medical Education Activities Data Collection	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
Form and Instruction	Registration Form	Registration Form	Registration Form.docx		Yes	Yes	Fillable Fileable
Form and Instruction	Post Course Evaluation Form	Post Course Evaluation Form	SAMHSA Joint Accreditation - Post-Course Evaluation.docx		Yes	Yes	Fillable Fileable
Form and Instruction	Follow-Up Evaluation	Follow-Up Evaluation	Follow-Up Evaluation (Template).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:	FR Citation:

Number of Respondents: 15,000	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	45,000	0	45,000	0	0	0
Annual IC Time Burden (Hours)	3,600	0	3,600	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Request Template	0930-0393 Fast Track Generic _ Submission Template.docx	08/22/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.