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Federal forms, ICRs, and supporting documents

Information Collection

Youth Baseline Questionnaire (Experimenter and Non-Trier)

IC 208708 under ICR 201502-0910-009 · OMB 0910-0753.

Documents and Forms
Document Name
Document Type
Other-Youth Assent
Other-Parent Permission
Other-Youth Media Tracking Screener
Other-E-mail reminder #1
Other-E-mail reminder #2
Other-E-mail reminder #3
Other-Media Tracking Screener and In
Information Collection (IC) Details

View Information Collection (IC)

Youth Baseline Questionnaire (Experimenter and Non-Trier)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Youth Assent 9 Attachment 6_Youth Assent 0910-0753.doc Yes No Printable Only
Other-Parent Permission 8 Attachment 6_Parent Permission 0910-0753.doc Yes No Printable Only
Other-Youth Media Tracking Screener and Instrument 12 Attachment 4_Media Tracking Screener and Instrument 0910-0753.doc Yes No Printable Only
Other-E-mail reminder #1 5 Email_reminder1_ 0910-0753.doc Yes No Printable Only
Other-E-mail reminder #2 6 Email_reminder2_ 0910-0753.doc Yes No Printable Only
Other-E-mail reminder #3 7 Email_reminder3_ 0910-0753.doc Yes No Printable Only
Other-Media Tracking Screener and Instrument 12 Attachment 4_Media Tracking Screener and Instrument 0910-0753.doc Yes No Printable Only

Health Immunization Management

 

2,686 0
   
Individuals or Households
 
   100 %

  Approved 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 2,686 0 0 0 0 2,686
Annual IC Time Burden (Hours) 1,343 0 0 0 0 1,343
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.