Information Collection

FASD Core Training Survey Pre-test

IC 220375 under ICR 202102-0920-003 · OMB 0920-1129.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1129 FASD Core Training Survey Pre-test	Form and Instruction
NOFAS Pre-Test Survey (FASD Prevention Identification & Alcohol Screening Pre)_obgyn non-sub changes_REVIEWED.docx	Other-WORD
NOFAS Pre-Test Survey (FASD Prevention Identification & Alcohol Screening Pre)_obgyn non-sub changes_REVIEWED.docx	Other-WORD
0920-1129 FASD Prevention, Identification & Alcohol Screening Pre- NOFAS Post-Test Survey (FASD Prevention Identification & Alcohol Post)_S....pdf	Form and Instruction
0920-1129 FASD Prevention, Identification & Alcohol Screening Pre- NOFAS Post-Test Survey (FASD Prevention Identification & Alcohol Post)_S....pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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 and Instruction	0920-1129	FASD Prevention, Identification & Alcohol Screening Pre-Training Evaluation	NOFAS Post-Test Survey (FASD Prevention Identification & Alcohol Post)_S....pdf		Yes	Yes	Fillable Fileable
Other-WORD			NOFAS Pre-Test Survey (FASD Prevention Identification & Alcohol Screening Pre)_obgyn non-sub changes_REVIEWED.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,013

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-4,013	4,013
Annual IC Time Burden (Hours)	-602	602
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.