Champion and Community Resources SSI

Evaluation of the Maternal and Child Health Bureau Pediatric Mental Health Care Access Program and the Screening and Treatment for Maternal Depression and Related Behavioral Disorders Program

OMB: 0906-0074

IC ID: 256680

Documents and Forms
Document Name
Document Type
Other-Semi Structured Interveiw
Other-Semi Structured Interveiw
Other-Semi Structured Interview
Other-Semi Structured Interview
Other-Semi Structured Interview
Other-Semi Structured Interview
Other-Semi Structured Interview
Other-Semi Structured Interview
Information Collection (IC) Details

View Information Collection (IC)

Champion and Community Resources SSI
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Semi Structured Interveiw Attachment B5 - PMHCA Champion SSI - Copy.docx Yes Yes Fillable Fileable
Other-Semi Structured Interview Attachment B6 - MDRBD Champion SSI - Copy.docx Yes Yes Fillable Fileable
Other-Semi Structured Interview Attachment B9 - PMHCA Community Resources SSI - Copy.docx Yes Yes Fillable Fileable
Other-Semi Structured Interview Attachment B10 - MDRBD Community Resources SSI - Copy.docx Yes Yes Fillable Fileable

Health Health Care Services

 

204 106
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 204 0 0 0 0 204
Annual IC Time Burden (Hours) 102 0 0 0 0 102
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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