Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Baseline Survey New 1000 250 0 Form and Instruction 0920-19ARD
Consent Form New 1235 247 0 Form and Instruction 0920-19ARD
Follow-up Survey New 2688 672 0 Form and Instruction 0920-19ARD
Operations Manager Interivew New 2 2 0 Form and Instruction 0920-19ARD
Provider Interview Guide New 3 3 0 Form and Instruction 0920-19ARD
Stay Independent Fall Risk Screener New 4035 404 0 Form and Instruction 0920-19ARD
Total burden requested under this ICR: 8963 1578 0  
To view an IC, click on IC Title