Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Baseline Questionnaire Modified 70 70 0 Form and Instruction NA
Form and Instruction NA
Form and Instruction NA
Form and Instruction NA
Form and Instruction 0920-1266
Form and Instruction 0920-1266
Contact Information Modified 70 1 0 Form and Instruction NA
Form and Instruction NA
Form and Instruction NA
Form and Instruction NA
Form and Instruction 0920-1266
Form and Instruction 0920-1266
Eligibility Screener Modified 140 7 0 Form and Instruction NA
Form and Instruction NA
Form and Instruction NA
Form and Instruction NA
Form and Instruction 0920-1266
Form and Instruction 0920-1266
Follow Up Questionnaire New 70 53 0 Form and Instruction 0920-1266
Form and Instruction 0920-1266
Interview Modified 15 23 0 Form and Instruction NA
Form and Instruction NA
Form and Instruction 0920-1266
Form and Instruction 0920-1266
Total burden requested under this ICR: 365 154 0  
To view an IC, click on IC Title