PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Prevention and Public Health Funds Evidence-Based Falls Prevention Program (Local Respondents)
New
834
820
0
Form and Instruction
1
Falls Program Information Sheet
Form
2
Participant Information
Form
3
Post Session Survey
Form
4
Attendance Log
Form
6
Host Organization
Prevention and Public Health Funds Evidence-Based Falls Prevention Program (Staff Respondents)
New
28
224
0
Form and Instruction
5
Falls Performance Report
Prevention and Public Health Funds Evidenced-Based Falls Prevention Program (Individuals)
New
10000
2000
0
Form and Instruction
2
Participant Information
Form
3
Post Session Survey
Total burden requested under this ICR:
10862
3044
0
To view an IC, click on IC Title
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