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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
1.1: IPV Screener 1
New
300
50
0
Other-Screener
1.2: IPV Screener 2
New
300
50
0
Other-Screener
1.3: IPV Screener 3
New
300
75
0
Other-Screener
2.1: TDV Screener 1
New
300
50
0
Other-Screener
2.2: TDV Screener 2
New
300
50
0
Other-Screener
2.3: TDV Screener 3
New
300
75
0
Other-Screener
Administration of data collection protocol and record-keeping
New
300
50
0
Other-Staff involvement in data collection
Contact information form for parents of youth younger than 18 (C.2)
New
300
30
0
Other-Contact Info
Locator section for adults (C.1)
New
300
30
0
Other-Location section
Participant recruitment
New
300
30
0
Other-Recruitment Efforts
Post screener questions for adults (C.3)
New
300
30
0
Other-Post Screener Questions
Post screener questions for youth (C.3)
New
300
30
0
Other-Post Screener Questions
Total burden requested under this ICR:
3600
550
0
To view an IC, click on IC Title
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