Information Collection

Parent injury follow-up survey

IC 215899 under ICR 201511-0920-011 · OMB 0920-1073.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Parent injury follow-up survey	Form
Parent injury follow-up survey AttachH-Inj Ath & Parent Interview_rev0323.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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
Form	none	Parent injury follow-up survey	AttachH-Inj Ath & Parent Interview_rev0323.docx		Yes	Yes	Fillable Fileable

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 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	683	683
Annual IC Time Burden (Hours)	114	114
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.