Adult/Caregiver Survey

Teen and Parent Surveys of Health (TAPS)

Documents and Forms

Document Name Document Type
Adult/Caregiver Survey Form and Instruction
Parent Survey of Health 2021 Att 11 Parent Caregiver Survey.docx Form and Instruction
Parent Survey of Health 2021 Att 11 Parent Caregiver Survey.docx Form and Instruction
Att 3 TAPS Parent Survey Screenshots.docx Screenshots IC Document
Att 3 TAPS Parent Survey Screenshots.docx Screenshots IC Document

Information Collection (IC) Details

IC Title:	Adult/Caregiver Survey	Agency IC Tracking Number:	0920-21GA

Is this a Common Form? No		IC Status: New

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	N/A	Parent Survey of Health 2021	Att 11 Parent Caregiver Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,634	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,634	2,634
Annual IC Time Burden (Hours)	878	878
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Screenshots	Att 3 TAPS Parent Survey Screenshots.docx	10/15/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.