Information Collection

Lifetime of Good Health Survey

IC 46757 under ICR 200701-0990-006 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Breasfeeding Guide - Disc Group Guide 5-26-06.doc Easy Guide to Breastfeeding Discussion Groups	IC Document
Easy Guide to Breastfeeding Survey FINAL 7-10-06.doc Easy Guide to Breasfeeding Survey	IC Document
Lifetime of Good Health Survey FINAL 7-10-06.doc Lifetime of Good Health	IC Document
Daybook Survey FINAL 7-10-06.doc Womens's Health Daybook	IC Document
Teen Survival Guide Survey FINAL 7-10-06.doc Teen Survival Guide	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 241.301

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

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 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
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Easy Guide to Breastfeeding Discussion Groups	Breasfeeding Guide - Disc Group Guide 5-26-06.doc	11/29/2006
Easy Guide to Breasfeeding Survey	Easy Guide to Breastfeeding Survey FINAL 7-10-06.doc	11/29/2006
Lifetime of Good Health	Lifetime of Good Health Survey FINAL 7-10-06.doc	11/29/2006
Womens's Health Daybook	Daybook Survey FINAL 7-10-06.doc	11/29/2006
Teen Survival Guide	Teen Survival Guide Survey FINAL 7-10-06.doc	11/29/2006

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