Demographic Survey

Formative Research on Community-Level Factors that Promote the Primary Prevention of Adverse Childhood Experiences (ACEs) and Opioid Misuse Among Children, Youth, and Families in Tribal American India

OMB: 0920-1351

IC ID: 247304

Information Collection (IC) Details

View Information Collection (IC)

Demographic Survey 0920-1351-22FR
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1351 Demographic Survey BIRCH Revised Attachment I Demographic Survey 5-12-2022.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

120 0
   
Individuals or Households
 
   0 %

  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 120 0 0 0 0 120
Annual IC Time Burden (Hours) 50 0 0 0 0 50
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Changes to Att I. Demographic Survey (track changes) BIRCH Changes to Attachment I Demographic Survey 5-12-2022.docx 05/25/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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