PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Instrument 1: Centralized Intake Administrator Screening Talking Points or Screening Email with Questions
Unchanged
9
3
0
Other-Intake Screener
Instrument 2: Centralized Intake Administrator and Other Staff Interview Protocol
Modified
42
63
0
Other-Interview
Instrument 3: Document Review Request
Unchanged
21
5
0
Other-Document Review Request
Instrument 4: Home Visiting Program Director and Other Staff Interview Protocol
Modified
28
28
0
Other-Interview
Instrument 5: Home Visitor and Other Staff Interview Protocol
Modified
42
42
0
Other-Interview
Instrument 6: Family Interview Protocol
Unchanged
42
42
0
Other-Interview
Instrument 7: Participant Characteristics Form
Modified
154
12
0
Other-Characteristics Form
On-site coordination
Unchanged
14
56
0
Other-On-site coordination
Total burden requested under this ICR:
352
251
0
To view an IC, click on IC Title