U.S. Department of Health and Human Services
If you do not know your User ID and Password, please refer to the pink flyer in the
You can also call our toll free number to obtain the information: 1-888-324-8337.
PLEDGE TO RESPONDENTS: The information you provide will be protected to the fullest extent allowable under Section 501(n) of
the Public Health Service Act (42 USC 290aa(n)). This law permits the public release of identifiable information about an
establishment only with the consent of that establishment and limits the use of the information to the purposes for which
it was supplied. With the explicit consent of eligible treatment facilities, information provided in response to survey
questions marked with an asterisk may be published in SAMHSA’s online Behavioral Health Treatment Services Locator,
the National Directory of Drug and Alcohol Abuse Treatment Programs, and other publically available listings.
Responses to non-asterisked questions will be published with no direct link to individual treatment facilities.
Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to,
a collection of information unless it displays a currently valid OMB control number. The OMB control number
for this project is 0930-0106. Public reporting burden for this collection of information is estimated to
average 40 minutes per respondent, per year, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 2-1057, Rockville, Maryland 20857.