Adult Survey

The Community Choice Demonstration

OMB: 2528-0337

IC ID: 262909

Documents and Forms
Document Name
Document Type
Other-Adult Survey
Other-Adult Survey
Other-Adult Survey
Other-Adult Survey
Other-Adult Survey
Other-Adult Survey
Other-Adult Survey
Other-Adult Survey
Information Collection (IC) Details

View Information Collection (IC)

Adult Survey
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Adult Survey Attachment M.1_The Obesity Type II Diabetes Risk Assessment_Survey_Baseline.docx Yes Yes Fillable Fileable
Other-Adult Survey Attachment M.2_The Obesity Type II Diabetes Risk Assessment_Survey_Follow-up.docx Yes Yes Fillable Fileable
Other-Adult Survey Attachment M.1_The Obesity & Type II Diabetes Risk Assessment_Survey_Baseline - CLEAN.docx Yes Yes Fillable Fileable
Other-Adult Survey Attachment M.2_The Obesity & Type II Diabetes Risk Assessment_Survey_Follow-up - CLEAN.docx Yes Yes Fillable Fileable

Community and Social Services Community and Regional Development

 

900 0
   
Individuals or Households
 
   100 %

  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 1,800 0 0 0 0 1,800
Annual IC Time Burden (Hours) 1,800 0 0 0 0 1,800
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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