Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
12-Month Follow-Up Participant Interview (Attachment K) Modified 1433 717 0 Other-Participant Survey
Other-K-1: SUD Program Participant Survey
Other-Survey
Other-K-3 12- to 18-Month Follow-Up Participant Survey
Baseline information form for participants (Attachments D) Unchanged 1000 250 0 Other-Standard BIF
Other-Tailored BIF - ARC Site
Other-Tailored BIF - CCC Site
Other-Tailored BIF - Franklin-Stark Site
Other-Tailored BIF - 2Gen-Chicago Site
Other-Tailored BIF - IPS FQHC site
Other-Tailored BIF - IPS SUD
Other-Tailored BIF - TANF-SNAP study
Contact update request form (Attachment E) Unchanged 1333 133 0 Other-
Participant Case Study Interview Guide (Attachment M) Unchanged 28 42 0 Other-Interview Guide
Program Managers, Staff, and Partners Interview Guide (Attachment L) Unchanged 134 201 0 Other-Interview Guide
Program Staff Case Study Interview Guide (Attachment N) Unchanged 28 28 0 Other-Interview Guide
Program Staff Survey (Attachment O) Unchanged 100 50 0 Other-Staff Survey
Program managers, staff, and partner interview guide - SUD Programs (Attachment F) Unchanged 20 30 0 Other-
Program managers, staff, and partner interview guide - Whole Family Approach Programs (Attachment G) Unchanged 14 21 0 Other-
Total burden requested under this ICR: 4090 1472 0  
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