Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Ages & Stages Questionnaire, Third Edition (ASQ-3) Removed 0 0 0 Other-Questionnaire
Client Wave 1 Survey Removed 0 0 0 Other-Survey
Client Wave 2 Survey Removed 0 0 0 Other-Survey
Client Wave 3 and 4 Survey Removed 0 0 0 Other-Survey
Evidence-Based Practice Attitudes Scale (EBPAS) Removed 0 0 0 Other-Survey
Family Needs Screener New 15000 3750 122475 Other-Survey
Fidelity Checklist (FC) Removed 0 0 0 Other-Checklist
Parenting Skills Assessment (PSA-10) Removed 0 0 0 Other-Assessment
Total burden requested under this ICR: 15000 3750 122475  
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