Information Collection

Parents/Caregivers

IC 277023 under ICR 202508-0930-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Client Contact For Parents/Caregivers	Form and Instruction
Form Client Contact For Client Contact Form Supplement for Parents Parents/Caregivers	Form and Instruction
Client Contact For Client Contact Form Supplement for Parents 988_Att G. Client Contact Disposition Form Supplement for Parents_CCDF-PS_032025_Clean.docx	Form and Instruction
Client Contact For Client Contact Form Supplement for Parents 988_Att G. Client Contact Disposition Form Supplement for Parents_CCDF-PS_032025_Clean.docx	Form and Instruction

IC Title:

Parents/Caregivers

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	Client Contact Form Supplement for Parents				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Parents/Caregivers

FR Citation: 74 FR 28264

Number of Respondents: 1,560

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,560	1,560
Annual IC Time Burden (Hours)	156	156
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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