Information Collection

School Health Services

IC 197637 under ICR 201307-0920-004 · OMB 0920-0445.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix G-3 Health Services School.doc	Other-WORD
Appendix E-1 School Participant Notification Document.docx Appendix E-1 School Participant Notification Document	IC Document
Appendix H-7 School- and Classroom-level Content Outlines.doc Appendix H-7 School- and Classroom-level Content Outlines	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Other-WORD			Appendix G-3 Health Services School.doc		Yes	Yes	Fillable Printable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 640

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	640	640
Annual IC Time Burden (Hours)	534	534
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix E-1 School Participant Notification Document	Appendix E-1 School Participant Notification Document.docx	06/24/2013
Appendix H-7 School- and Classroom-level Content Outlines	Appendix H-7 School- and Classroom-level Content Outlines.doc	06/24/2013

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