Time 2 Supplemental Questions

Attachment E

Time 2 Supplemental Questions

Form Approved

OMB No. 0920-XXXX

Exp. Date xx/xx/20xx

Public reporting burden of this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).

1. Several weeks ago, the first 2020 School Health Profiles {principal/lead health education teacher} Questionnaire was completed for this school. Thinking back to that questionnaire, were you the person at this school that completed it?

• Yes

• No

2. Often when schools complete questionnaires such as this, they will print out or make a copy of the form that was completed. Did you, or the person who completed the first 2020 School Health Profiles Questionnaire, print out or make a copy of the completed questionnaire?

• Yes

• No → GO TO Q4

• I don’t know if a copy of the first 2020 School Health Profiles Questionnaire was made → GO TO Q4

3. When completing this second 2020 School Health Profiles Questionnaire, did you reference the copy of the first questionnaire that was completed?

• Yes

• No

1. When completing this second 2020 School Health Profiles Questionnaire, did you reference any school records or information that you did not use the first time you completed the questionnaire?

• Yes, I referenced school records or information for this second questionnaire that I did not use for the first questionnaire.

• No, I referenced the same school records or information for both the first and second questionnaires.

• No, I did not reference any school records or information for the second questionnaire.

4. Since completing the first 2020 School Health Profiles Questionnaire, have any school health programs or policies asked about on this questionnaire changed?

• Yes

• No