Information Collection

Developing a Sexual Consent Norms Instrument - Confirmatory Survey of Early Adolescents

IC 196368 under ICR 201102-0920-015 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 28 Developing a Sexual Consent Norms Instrument - Confirmatory Survey of Early Adolescents	Form and Instruction
28 Early Adolescent Survey Appendix 28_Phase 2 Early Adolescent Survey (2)_revised 1_18.docx	Form and Instruction
Appendix 14_Phase 2 Parental Informed Consent (2)_revised 1_21.docx Appendix 14_Phase 2 Parental Informed Consent (2)_revised 1_21	IC Document
Appendix 16_Phases 2 and 4 Adolescent Assent.docx Appendix 16_Phases 2 and 4 Adolescent Assent	IC Document
Appendix 9_Phase 3 Parental Consent_revised 1_18.docx Appendix 9_Phase 3 Parental Consent_revised 1_18	IC Document
Appendix 14_Phase 2 Parental Informed Consent (2)_revised 1_21.docx Appendix 14_Phase 2 Parental Informed Consent (2)_revised 1_21	IC Document
Appendix 11_Phase 3 Adolescent Assent.docx Appendix 11_Phase 3 Adolescent Assent	IC Document
Appendix 20_Phases 1 and 3 Adolescent Recruitment Flyer_revised 1_18.docx Appendix 20_Phases 1 and 3 Adolescent Recruitment Flyer_revised 1_18	IC Document
Appendix 15_Phase 4 Parental Informed Consent_revised 1_21.docx Appendix 15_Phase 4 Parental Informed Consent_revised 1_21	IC Document
Appendix 16_Phases 2 and 4 Adolescent Assent.docx Appendix 16_Phases 2 and 4 Adolescent Assent	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	28	Early Adolescent Survey	Appendix 28_Phase 2 Early Adolescent Survey (2)_revised 1_18.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix 14_Phase 2 Parental Informed Consent (2)_revised 1_21	Appendix 14_Phase 2 Parental Informed Consent (2)_revised 1_21.docx	02/14/2011
Appendix 16_Phases 2 and 4 Adolescent Assent	Appendix 16_Phases 2 and 4 Adolescent Assent.docx	02/14/2011
Appendix 9_Phase 3 Parental Consent_revised 1_18	Appendix 9_Phase 3 Parental Consent_revised 1_18.docx	02/14/2011
Appendix 14_Phase 2 Parental Informed Consent (2)_revised 1_21	Appendix 14_Phase 2 Parental Informed Consent (2)_revised 1_21.docx	02/14/2011
Appendix 11_Phase 3 Adolescent Assent	Appendix 11_Phase 3 Adolescent Assent.docx	02/14/2011
Appendix 20_Phases 1 and 3 Adolescent Recruitment Flyer_revised 1_18	Appendix 20_Phases 1 and 3 Adolescent Recruitment Flyer_revised 1_18.docx	02/14/2011
Appendix 15_Phase 4 Parental Informed Consent_revised 1_21	Appendix 15_Phase 4 Parental Informed Consent_revised 1_21.docx	02/14/2011
Appendix 16_Phases 2 and 4 Adolescent Assent	Appendix 16_Phases 2 and 4 Adolescent Assent.docx	02/14/2011

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