DTAC-banner

CCP Data Forms and Training

Access data collection forms and survey templates to evaluate your Crisis Counseling Assistance and Training Program (CCP), and learn how to use them.

Crisis counselors are required to document the services they provide. Collecting data on disaster survivors and the services they receive supports ongoing evaluation of your Crisis Counseling Assistance and Training Program (CCP).

CCP data collection forms have an Office of Management and Budget (OMB) expiration date of September 30, 2018. For CCP grants awarded prior to August 31, 2015, there are different data collection forms and procedures. Please contact SAMHSA DTAC at 800-308-3515 or dtac@samhsa.hhs.gov if you need assistance with the prior forms, which expired August 31, 2015.

Basic Data Collection Forms and Training

There are three basic forms submitted to CCP team leaders after each encounter:

Access the Basic Forms Training for crisis counseling staff to learn how to fill out each one. The webinar is about 55 minutes. CCP Data Forms: Frequently Asked Questions (PDF | 209 KB) is also helpful.

These forms are also available in Spanish:

Assessment and Referral Tools and Training

Service providers also use advanced tools known as assessment and referral tools. These tools include:

These forms are also available in Spanish:

These tools collect data on people who are experiencing serious reactions, or who have encountered service providers three or more times. Training on how to use assessment and referral tools is presented in three parts:

  • Section 1 provides an overview of CCP assessment and referral tools and their purpose. This training is about 10 minutes.
  • Section 2 explains how to complete the Adult Assessment and Referral Tool and how to use the results to make appropriate referrals. This training is about 20 minutes.
  • Section 3 explains how to complete the Child/Youth Assessment and Referral Tool and use the results to make appropriate referrals. This training is about 30 minutes.

Feedback Surveys and Forms

Feedback from disaster survivors and service providers helps grantees improve CCP services in real time and keep program goals on track.

Participant Feedback

Use the Participant Feedback Survey (PDF | 85 KB) to collect feedback from disaster survivors who have received CCP services. This survey is also available in Spanish (PDF | 219 KB)

Use the following resources to help you collect feedback from CCP participants:

Service Provider Feedback

Use the Service Provider Feedback Form (PDF | 148 KB) to collect feedback from CCP crisis counselors. This survey is also available in Spanish (PDF | 203 KB).

Use the following resources to help you collect feedback from CCP service providers:

Last Updated: 12/27/2017