Information Collection

LifeWork Strategies NIH Parenting Coach Request Form (OD)

IC 257288 under ICR 202301-0925-002 · OMB 0925-0766.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0766 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 LifeWork Strategies NIH Parenting Coach Request Form (OD)	Form and Instruction
Form 1 LifeWork Strategies NIH Parenting Coach Request Form (OD)	Form and Instruction
1 LifeWork intake survey LifeWork intake instrument.docx	Form and Instruction
1 LifeWork intake survey LifeWork intake instrument.docx	Form and Instruction
NIH+LWS Citizen Science Generic - Parenting Coach Online Request_rev_kc.docx sub-study for LifeWork intake survey	IC Document
NIH+LWS Citizen Science Generic - Parenting Coach Online Request_rev_kc.docx sub-study for LifeWork intake survey	IC Document
LWS - NIH Online Parent Coaches Flyer.pdf LifeWork flyer	IC Document
LWS - NIH Online Parent Coaches Flyer.pdf LifeWork flyer	IC Document
Parenting Coaches & Elder Dependent Care Coaches Global - Child and Family Programs.docx email followup letters	IC Document
Parenting Coaches & Elder Dependent Care Coaches Global - Child and Family Programs.docx email followup letters	IC Document

IC Title:

LifeWork Strategies NIH Parenting Coach Request Form (OD)

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	LifeWork intake survey	LifeWork intake instrument.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 78

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	78	78
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
sub-study for LifeWork intake survey	NIH+LWS Citizen Science Generic - Parenting Coach Online Request_rev_kc.docx	12/08/2022
LifeWork flyer	LWS - NIH Online Parent Coaches Flyer.pdf	12/08/2022
email followup letters	Parenting Coaches & Elder Dependent Care Coaches Global - Child and Family Programs.docx	12/08/2022

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