[NCHHSTP] Evaluation of Safe Spaces in CDC-directly funded Community-based Organizations (CBOs)

ICR 202212-0920-002

OMB: 0920-1403

Federal Form Document

Forms and Documents

Document Name	Status
Form 0920- Staff Interview Form and Instruction	New
Form 0920- Client Survey (Participant) Form	New
Form 0920 Eligibility Screener Form and Instruction	New
Privacy Act Checklist.docx Supplementary Document	2023-01-06
Att 1_Section 301 of the Public Health Service Act.docx Supplementary Document	2023-01-06
SS B_121922.docx Supporting Statement B	2023-01-06
SS A_121922.docx Supporting Statement A	2023-01-06

IC Document Collections

IC ID	Document Title	Status
257787	Staff Interview Form and Instruction	New
257786	Client Survey (Participant) Form	New
257785	Eligibility Screener Form and Instruction	New