Information Collection

School Health Resources Assessment: Awareness, Satisfaction, and Utility

IC 216542 under ICR 201412-0920-011 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att. A - Asessment Instrument Word Version.docx	Other-WORD
Att. B Assessment Instrument Web Version.docx	Other-Web Version
Att. C List of School Health Coordinators.docx Att C_ List of SCHOOL Health Coordinators	IC Document
Att. D Notification Email.docx Att D_Notification Email	IC Document
Att. E - Reminder Email (Week 2).docx Att E_ Reminder E-mail Week 2	IC Document
Att. F - Reminder Email (Week 3).docx Att F_Second Reminder Email Week 3	IC Document
SCH-TOOL-SSA.docx Supporting Statement A	IC Document
SCH-TOOL-SSB.docx Supporting Statement B	IC Document

IC Title:

School Health Resources Assessment: Awareness, Satisfaction, and Utility

Agency IC Tracking Number:

15AIF

IC Status: New

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			Att. A - Asessment Instrument Word Version.docx		Yes	Yes	Fillable Printable
Other-Web Version			Att. B Assessment Instrument Web Version.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 85

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	85	85
Annual IC Time Burden (Hours)	16	16
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att C_ List of SCHOOL Health Coordinators	Att. C List of School Health Coordinators.docx	05/11/2015
Att D_Notification Email	Att. D Notification Email.docx	05/11/2015
Att E_ Reminder E-mail Week 2	Att. E - Reminder Email (Week 2).docx	05/11/2015
Att F_Second Reminder Email Week 3	Att. F - Reminder Email (Week 3).docx	05/11/2015
Supporting Statement A	SCH-TOOL-SSA.docx	05/11/2015
Supporting Statement B	SCH-TOOL-SSB.docx	05/11/2015

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