Program Eligibility Protocol

Assessing the Use of Informal Contacts to Promote Caregivers’ Engagement and Satisfaction with Early Childhood Home Visiting Through Rapid Cycle Learning

Documents and Forms

Document Name Document Type
Form 1 Program Eligibility Protocol Form and Instruction
1 Program Eligibility Protocol Appendix E_Instrument 1_Informal Contacts 4.18.24.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Program Eligibility Protocol	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	1	Program Eligibility Protocol	Appendix E_Instrument 1_Informal Contacts 4.18.24.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16	Number of Respondents for Small Entity: 16

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	16	16
Annual IC Time Burden (Hours)	16	16
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.