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Athlete injury follow-up survey
Improving the Understanding of Traumatic Brain Injury through Policy and Program Evaluation
OMB: 0920-1073
IC ID: 215898
OMB.report
HHS/CDC
OMB 0920-1073
ICR 201503-0920-018
IC 215898
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1073 can be found here:
2015-11-25 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Athlete injury follow-up survey
Form
Injury follow-up interview
AttachH-Inj Ath & Parent Interview_rev0323.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Athlete injury follow-up 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
Injury follow-up interview
AttachH-Inj Ath & Parent Interview_rev0323.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
Records of subjects in health promotion and educational studies
FR Citation:
51 FR 42484
Number of Respondents:
683
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
683
0
683
0
0
0
Annual IC Time Burden (Hours)
114
0
114
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.