Youth Health and Climate School Survey

Assessing School-centered HIV/STD Prevention Efforts in a Local Education Agency

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1035 can be found here:

Documents and Forms

Document Name Document Type
Youth Health and Climate School Survey Form
Youth Health and Climate School Survey Att 3 Youth Health And School Climate Questionnaire_2014-08-13.pdf Form

Information Collection (IC) Details

IC Title:	Youth Health and Climate School Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Youth Health and Climate School Survey	Att 3 Youth Health And School Climate Questionnaire_2014-08-13.pdf		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	11,000	11,000
Annual IC Time Burden (Hours)	7,333	7,333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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