Information Collection
State, Local and/or Tribal Agencies
IC 183226 under ICR 201103-0584-005 · OMB 0584-0548.
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0548 can be found here:
Documents and Forms
Document Name Document Type |
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Other-PeerCounsBackQuest |
Other- DemPerProgForm |
Other-Study Enrollment Form |
Other-Decline Form |
Other-Decline Form Spanish |
Other-STUDY INVITATION TRACKING FORM |
Other- Refusal Withdraw |
Other-Contact Log Abstraction Form |
Other-LWA Staff Interview Guide |
Other-Interview Guide 2 |
Other-nterview Guide 3 |
0584-0548 State Agency Survey paper 6-09 formatted.pdfmobile.checkbox.com/abtassociates/WIC_PEERC_Intro.survey Other-SA Survey Screenshot |
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IC Document |
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IC Document |
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IC Document |
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IC Document |
Information Collection (IC) Details