Sample Instrument: Parent/Caregiver Survey

Assessments to Inform Program Refinement for HIV, other STD, and Pregnancy Prevention among Middle and High-School Aged Youth

OMB: 0920-1235

IC ID: 235565

Documents and Forms
Document Name
Document Type
Other-WORD
Information Collection (IC) Details

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Sample Instrument: Parent/Caregiver Survey 0920-1235
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Att 6-Sample Instrument-Parent-Caregiver Survey.docx No   Paper Only

Health Illness Prevention

 

7,500 0
   
Individuals or Households
 
   0 %

  Requested 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 15,000 0 15,000 0 0 0
Annual IC Time Burden (Hours) 6,250 0 6,250 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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