ATTACHMENT C20: Health Risk Behavior Survey (High School)

Longitudinal follow-up of Youth with Attention-Deficit/Hyperactivity Disorder identified in Community Settings: Examining Health Status, Correlates, and Effects associated with treatment for ADHD

Documents and Forms

Document Name Document Type
Form 19 ATTACHMENT C20: Health Risk Behavior Survey (High School) Form
19 ATTACHMENT C20: Health Risk Behavior Survey (High School Attachment C20 Child Health Risk Behavior Survey High School.doc Form

Information Collection (IC) Details

IC Title:	ATTACHMENT C20: Health Risk Behavior Survey (High School)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	19	ATTACHMENT C20: Health Risk Behavior Survey (High School)	Attachment C20 Child Health Risk Behavior Survey High School.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0136 - Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 153	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	153	-1,443	1,596
Annual IC Time Burden (Hours)	64	-16	80
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.