Middle School Perspectives on Sexual Health Education in Fort Worth Independent School District

Formative Research and Tool Development

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0840 can be found here:

Documents and Forms

Document Name Document Type
Middle School Perspectives on Sexual Health Education in Fort Worth Independent School District Form and Instruction
Middle School Focus Group Guide Att 3-Middle School Focus Group Guide.docx Form and Instruction
Att 1-PHS Act Legislation.pdf Authorizing Legislation: Public Health Service Act IC Document
Att 2-60 Day FRN.pdf 60-day FRN for the generic 0920-0840 clearance IC Document
Att 4-Consultants_on_the_IC.docx Consultants on the FWISD Information Collection IC Document
Att 5-Documentation of IRB Approval.pdf IRB Approval IC Document
Att 6-Parental Consent Form.docx Parental Consent Form IC Document
Att 7-Student Verbal Assent Language.docx Student Verbal Assent IC Document
Att 8-Description of Changes.docx Changes since Spring 2016 Information Collection IC Document
Att 9-NonDisclosure Agreement.pdf FWISD Non-disclosure Agreement IC Document
SSA-2017-02-16.docx Supporting Statement Part A IC Document
SSB-2017-02-15.docx Supporting Statement Part B IC Document

Information Collection (IC) Details

IC Title:	Middle School Perspectives on Sexual Health Education in Fort Worth Independent School District	Agency IC Tracking Number:	0920-17TK

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 and Instruction	N/A	Middle School Focus Group Guide	Att 3-Middle School Focus Group Guide.docx		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 48	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	48	48
Annual IC Time Burden (Hours)	72	72
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Authorizing Legislation: Public Health Service Act	Att 1-PHS Act Legislation.pdf	02/16/2017
60-day FRN for the generic 0920-0840 clearance	Att 2-60 Day FRN.pdf	02/16/2017
Consultants on the FWISD Information Collection	Att 4-Consultants_on_the_IC.docx	02/16/2017
IRB Approval	Att 5-Documentation of IRB Approval.pdf	02/16/2017
Parental Consent Form	Att 6-Parental Consent Form.docx	02/16/2017
Student Verbal Assent	Att 7-Student Verbal Assent Language.docx	02/16/2017
Changes since Spring 2016 Information Collection	Att 8-Description of Changes.docx	02/16/2017
FWISD Non-disclosure Agreement	Att 9-NonDisclosure Agreement.pdf	02/16/2017
Supporting Statement Part A	SSA-2017-02-16.docx	02/16/2017
Supporting Statement Part B	SSB-2017-02-15.docx	02/16/2017

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