Community Capacity/Readiness Assessment

Evaluation of Dating Matters: Strategies to Promote Healthy Teen Relationships

Documents and Forms

Document Name Document Type
Community Capacity/Readiness Assessment Form and Instruction
Community Capacity/Readiness Assessment Atmt JJJJ - Community_Capacity_and_Readiness_Assessment.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Community Capacity/Readiness Assessment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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	none	Community Capacity/Readiness Assessment	Atmt JJJJ - Community_Capacity_and_Readiness_Assessment.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-80	80
Annual IC Time Burden (Hours)	-80	80
Annual IC Cost Burden (Dollars)	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.