Information Collection Request

National Family Caregiver Support Program (NFCSP) Outcome Evaluation

ICR 201510-0985-001 · OMB 0985-0052 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Comparison group care recipients - 12 month followup Form and Instruction New Available
Form 1 Comparison group of care recipients - Baseline Form and Instruction New Available
Form 1 Comparison group non-NFCSP family caregivers - 12 month followup Form and Instruction New Available
Form 1 Comparison group non-NFCSP family caregivers - 6 month followup Form and Instruction New Available
Form 1 Comparison Group non-NFCSP family caregivers - Baseline Form and Instruction New Available
Form 1 National Family Caregiver Support Program (NFCSP) Outcome Evaluation Form and Instruction New Available
Form 1 Care Recipients of NFCSP Clients Form and Instruction New Available
Form 1 National Family Caregiver Support Program Outcome Evaluation - 12 month followup Form and Instruction New Available
Form 1 National Family Caregiver Support Program (NFCSP) Outcome Evaluation 6 month follow up Form and Instruction New Available
Form 1 National Family Caregiver Support Program Outcome Evaluation (Baseline) Form and Instruction New Available
HHS Information Technology Security Program PIA Guide_v1-caregiver outcome evaluation-CLEAN 3-2-16.docx Supplementary Document Uploaded 2016-03-08 Available
ACL_CaregiverOutcomeEvaluation_OMB_PRA_SectionB_August_31_2015.docx Supporting Statement B Uploaded 2015-10-06 Available
CaregiverOutcomeEvaluation_PRA_SectionA_Passback_CLEAN 3-2-16 v2.docx Supporting Statement A Uploaded 2016-03-08 Available

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2019 36 Months From Approved
12,500 0 0
5,514 0 0
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 12,500 0 0 12,500 0 0
Annual Time Burden (Hours) 5,514 0 0 5,514 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No