View Information Collection (IC)

View Information Collection (IC)

[NCHHSTP] DASH DEMO: LGBTQ Inclusivity Toolkit Evaluation 2022-2024 0920-0840-23GM
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Climate Interview Consent and Guide Att 1_Staff Climate Interview Guide District & School Staff.docx Yes No Fillable Fileable
Form and Instruction n/a School Staff Survey – Pre & Post Toolkit Att 2_School Staff Survey in SurveyMonkey.pdf Yes Yes Fillable Fileable
Form and Instruction n/a Monthly Report Form Att 3_Monthly Report Form.docx Yes Yes Fillable Fileable
Form and Instruction n/a Post-Pilot Feedback Interview Guide Att 4_Post-Pilot Feedback Inter Guide.docx Yes No Fillable Fileable
Instruction Att 10_Consent Form.docx Yes No Fillable Fileable
Form and Instruction n/a School Staff Survey – Pre & Post Toolkit (Word) Att 2_School Staff Survey&Consent.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

451 0
   
Individuals or Households
 
   80 %

  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 1,353 0 1,353 0 0 0
Annual IC Time Burden (Hours) 313 0 313 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA SSA-LGBTQ Inclusivity Toolkit Clean 6-27-23_final.docx 07/06/2023
SSB SSB - LGBTQ Inclusivity Toolkit_final.docx 07/06/2023
Authorizing Legislation Att 5_Auth Legislation.docx 07/06/2023
60 Day FRN Att 6_60day_FRN.pdf 07/06/2023
ICF IRB Approval Att 7_ICF IRB Approval_2021-248.pdf 07/06/2023
ICF IRB Determination Att 7a_ICF Notice IRB Determination_10.26.22.pdf 07/06/2023
PIA Att 8_PIA No PII.pdf 07/06/2023
Respondent Universe Att 9_Respondent Universe_final.docx 07/06/2023
Project Determination Project Determination_LGBTQ Toolkit_04.17.23.pdf 07/06/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.