Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2016 Adult Day Services Center Questionnaire-Version B Removed 0 0 0 Form NONE
2016 Adult Day Services Center Questions-Version A Removed 0 0 0 Form NONE
2016 Residential Care Community Questions-Version A Removed 0 0 0 Form NONE
2016 Residential Care Community Questions-Version B Removed 0 0 0 Form NONE
ADSC Provider Questionnaire New 1419 710 0 Form and Instruction 0920-0943
Data Retrieval Telephone Call Removed 0 0 0 Other-WORD
RCC Provider Questionnaire New 1589 795 0 Form and Instruction 0920-0943
RCC/ADSC Contact Confirmation Call Script New 3740 312 0 Form 0920-0943
RCC/ADSC Sampling and Services User Questionnaire New 3008 1504 0 Form and Instruction 0920-0943
RCC/ADSC Screener and Appointment Setting Call Script New 3740 935 0 Form 0920-0943
Total burden requested under this ICR: 13496 4256 0  
To view an IC, click on IC Title