SUPRT-Client

SAMHSA Unified Performance Reporting Tool (SUPRT)

Documents and Forms

Document Name Document Type
Form SUPRT Client Level SUPRT-Client Form and Instruction
Form SUPRT Client Level SUPRT-Client Form and Instruction
SUPRT Client Level SUPRT Client Level Tool SUPRT-Client-Clean.docx Form and Instruction
SUPRT Client Level SUPRT Client Level Tool SUPRT-Client-Clean.docx Form and Instruction

Information Collection (IC) Details

IC Title:	SUPRT-Client	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	SUPRT Client Level Tool	SUPRT Client Level Tool	SUPRT-Client-Clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: SUPRT Client	FR Citation: 75 FR 28264

Number of Respondents: 1,062,196	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	1,062,196	1,062,196
Annual IC Time Burden (Hours)	203,087	203,087
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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