Information Collection

Heads Up: Concussions in High School Sports

IC 44892 under ICR 200608-0920-001 · OMB 0920-0674.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Appendix D and App Heads Up: Concussions in High School Sports	Form and Instruction
Appendix D and App Heads Up: Concussions in High School Sports 0920-0674 Heads Up OMB package 05 10 06 submitted to OMB 8.22.06.doc	Form and Instruction
0920-0674 Heads Up OMB package 05 10 06 submitted to OMB 8.22.06.doc Heads Up: Concussions in High School Sports	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Appendix D and Appendix E	Heads Up: Concussions in High School Sports	0920-0674 Heads Up OMB package 05 10 06 submitted to OMB 8.22.06.doc		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,400	1,400
Annual IC Time Burden (Hours)	233	233
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Heads Up: Concussions in High School Sports	0920-0674 Heads Up OMB package 05 10 06 submitted to OMB 8.22.06.doc	08/22/2006

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