OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Children's Heart Health Promotion Tracker

IC 191375 under ICR 200911-0925-006 · OMB 0925-0609.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Children's Heart Health Promotion Tracker
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2 Screener NHLBI Attachment 4 - Screener Instrument.docx Yes Yes Paper Only
Form and Instruction 1 Survey NHLBI Attachment 1 - Survey Instrument.docx Yes Yes Paper Only

Health Consumer Health and Safety

 

1,175 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,175 0 1,175 0 0 0
Annual IC Time Burden (Hours) 196 0 196 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.