"Talk. They Hear You" - Parents

Pretesting of Substance Abuse Prevention and Treatment and Mental Health Services Communications Messages

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0196 can be found here:

Documents and Forms

Document Name Document Type
Form Focus Group Protoc "Talk. They Hear You" - Parents Form and Instruction
Focus Group Protoc Focus Group Protocol Attachment A 2016_7_19_OMB Package_UAD_Community Conversations_Focus Group Protocol.docx Form and Instruction
Screener Screener Attachment B 2016_7_20_UAD Community dialogue_ PSA Screener.docx Form and Instruction
Consent Form Consent Form Attachment C 2016_7_18_UAD_Community dialogue_Consent Form.docx Form and Instruction
Facilitator Guide Facilitator Guide Attachment D 2016_7_19_UAD Community dialogue_Focus Group Guide.docx Form and Instruction
TransLet-8doc.doc Transmittal Letter IC Document
2016_07_25_OMB 2016_Package_UAD_Community conversations_Focus Group.docx Justification IC Document

Information Collection (IC) Details

IC Title:	"Talk. They Hear You" - Parents	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Focus Group Protocol	Focus Group Protocol	Attachment A 2016_7_19_OMB Package_UAD_Community Conversations_Focus Group Protocol.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Screener	Screener	Attachment B 2016_7_20_UAD Community dialogue_ PSA Screener.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Consent Form	Consent Form	Attachment C 2016_7_18_UAD_Community dialogue_Consent Form.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Facilitator Guide	Facilitator Guide	Attachment D 2016_7_19_UAD Community dialogue_Focus Group Guide.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	88	88
Annual IC Time Burden (Hours)	64	64
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Transmittal Letter	TransLet-8doc.doc	07/25/2016
Justification	2016_07_25_OMB 2016_Package_UAD_Community conversations_Focus Group.docx	07/25/2016

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