Information Collection Request

A Survey of the Knowledge, Attitudes, and Practice of Medical and Allied Health Professionals Regarding Fetal Alcohol Exposure

ICR 200803-0920-003 · OMB 0920-0692 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 2. Selected Survey (one of 5) Form Modified Available
0920-0692 RevisionPart_B_01_10_08.doc Supporting Statement B Uploaded 2008-01-18 Available
appendix_G_Allied_health.doc Supplementary Document Uploaded 2008-02-28 Available
Appendix_F_ Family Physicians.doc Supplementary Document Uploaded 2008-02-28 Available
Appendix_E_psychologists.doc Supplementary Document Uploaded 2008-02-28 Available
appendix_D_Jan_08_OBGYN surveydoc.doc Supplementary Document Uploaded 2008-02-28 Repair queued
Appendix_K_Pediatrics FAS Survey Article.pdf Supplementary Document Uploaded 2008-01-18 Available
Appendix_I_Sample_Reminder_Postcard1.doc Supplementary Document Uploaded 2008-01-18 Repair queued
Appendix_H_Sam ltr to_Provider2.doc Supplementary Document Uploaded 2008-01-18 Repair queued
Appendix_ A2.pdf Supplementary Document Uploaded 2008-01-18 Available
Appendix_ A1.pdf Supplementary Document Uploaded 2008-01-18 Available
Appendix_J_Clinician's Guide.pdf Supplementary Document Uploaded 2008-01-18 Available
SS Revision_CLEAN_2_27_08.doc Supporting Statement A Uploaded 2008-02-28 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
7161 2. Selected Survey (one of 5) Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2011 36 Months From Approved 08/31/2008
900 0 4,000
375 0 2,000
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
2. Selected Survey (one of 5) 1 Pediatricians

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 900 4,000 0 -3,100 0 0
Annual Time Burden (Hours) 375 2,000 0 -1,625 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No