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FASD Core Training Survey Pre-test
Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships
OMB: 0920-1129
IC ID: 220375
OMB.report
HHS/CDC
OMB 0920-1129
ICR 202102-0920-003
IC 220375
( )
Documents and Forms
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
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
FASD Core Training Survey Pre-test
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
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
Federal Enterprise Architecture Business Reference Module
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 %
Approved
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
0
0
0
-4,013
4,013
0
Annual IC Time Burden (Hours)
0
0
0
-602
602
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.