Information Collection

Parent or Caregiver Web Survey

IC 264296 under ICR 202409-0925-007 · OMB 0925-0781.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0781 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Parent or Caregiver Web Survey Form
1 Survey Att H - Parent or Caregiver Web Survey - Revised Sept 2024.docx Form
1 Survey Att H - Parent or Caregiver Web Survey - Revised Sept 2024.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Parent or Caregiver Web Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	1	Survey	Att H - Parent or Caregiver Web Survey - Revised Sept 2024.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	15	15
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.