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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
1. MUSE Caregiver Enrollment Form 7.9.18_CLEAN
Unchanged
434
35
0
Other-Enrollment Form
10. Program Implementation Survey 7.9.18 CLEAN
Unchanged
11
3
0
Other-Survey
11. MUSE Home Visitor Interview Questions 7.9.18
Unchanged
14
28
0
Other-Interview Questions
12. MUSE Program Coordinator-Manager and Program Director Interview Questions 7.9.18
Unchanged
11
17
0
Other-Interview Questions
13. MUSE Local Evaluator Interview Questions 7.9.18
Unchanged
10
15
0
Other-Interview Questions
14. MUSE Caregiver Interview Questions 7.9.18 CLEAN
Unchanged
17
17
0
Other-Interview Questions
15. MUSE Implementation Logs 7.9.18 CLEAN
Unchanged
216
145
0
Other-Implementation Logs
16. MUSE Administrative Data Elements
Modified
36
864
0
Other-Data Elements
2. MUSE Caregiver Baseline Survey
Modified
188
47
0
Other-Caregiver Baseline Survey
Other-Caregiver Baseline Survey - PHONE
3. MUSE Caregiver 6 12 Month Follow-Up Survey
Modified
254
127
0
Other-Follow Up Survey
Other-Caregiver FollowUp Survey - PHONE
4. MUSE Rapid Reflect Caregiver 7.9.18 CLEAN
Unchanged
3408
273
0
Other-Questionnaire
5. MUSE Rapid Reflect Home Visitor 7.25.18 CLEAN
Unchanged
3102
620
0
Other-Questionnaire
6. MUSE Home Visitor Survey 7.25.18 CLEAN
Unchanged
27
32
0
Other-Survey
7. MUSE Program Coordinator-Manager Survey 7.25.18 CLEAN
Unchanged
7
7
0
Other-Survey
8. MUSE Program Director Survey 7.25.18 CLEAN
Unchanged
7
5
0
Other-Survey
9. MUSE Local Program Evaluator Survey 7.9.18 CLEAN
Unchanged
10
5
0
Other-Survey
Total burden requested under this ICR:
7752
2240
0
To view an IC, click on IC Title