Local Health Department Capacity and Readiness

Evaluation of Dating Matters: Strategies to Promote Healthy Teen Relationships

OMB: 0920-0941

IC ID: 201410

Information Collection (IC) Details

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Local Health Department Capacity and Readiness
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form None Local Health Department Capacity and Readiness Atmt_SS_Local_Health_Department_Capacity_and_Readiness_Survey[1].docx Yes Yes Fillable Fileable

Health Health Care Services

 

16 0
   
Individuals or Households
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 16 0 0 0 0 16
Annual IC Time Burden (Hours) 32 0 0 0 0 32
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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