Information Collection

Sample Instrument: Parent Interview/Focus Group Guide

IC 251122 under ICR 202112-0920-005 · OMB 0920-1235.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1235 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1235 Sample Instrument: Parent Interview/Focus Group Guide	Form and Instruction
0920-1235 Sample Instrument: Parent Interview/Focus Group Guide Att 7-Sample Instrument-Parent-Caregiver Interview-Focus Group Guide.docx	Form and Instruction
0920-1235 Sample Instrument: Parent/Caregiver Survey Att 6-Sample Instrument-Parent-Caregiver Survey.docx	Form and Instruction
0920-1235 Youth Interview/Focus Group Guide Att 5-Sample Instrument-Youth Focus Group Guide.docx	Form and Instruction
0920-1235 Sample Instrument: Youth Pre/Post Questionnaire Att 4-Sample Instrument-Youth Pre-Post Questionnaire.docx	Form and Instruction
0920-1235 Sample Instrument: Youth Questionnaire Att 3-Sample Instrument-Youth Questionnaire.docx	Form and Instruction

IC Title:

Sample Instrument: Parent Interview/Focus Group Guide

Agency IC Tracking Number:

0920-1235

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	0920-1235	Sample Instrument: Parent Interview/Focus Group Guide	Att 7-Sample Instrument-Parent-Caregiver Interview-Focus Group Guide.docx	No	Paper Only
Form and Instruction	0920-1235	Sample Instrument: Parent/Caregiver Survey	Att 6-Sample Instrument-Parent-Caregiver Survey.docx	No	Fillable Fileable
Form and Instruction	0920-1235	Youth Interview/Focus Group Guide	Att 5-Sample Instrument-Youth Focus Group Guide.docx	No	Paper Only
Form and Instruction	0920-1235	Sample Instrument: Youth Pre/Post Questionnaire	Att 4-Sample Instrument-Youth Pre-Post Questionnaire.docx	No	Fillable Fileable
Form and Instruction	0920-1235	Sample Instrument: Youth Questionnaire	Att 3-Sample Instrument-Youth Questionnaire.docx	No	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 43,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	87,000	87,000
Annual IC Time Burden (Hours)	57,584	57,584
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.