Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
"Talk. They Hear You." Community Partner License Survey New 260 21 0 Form and Instruction Talk.TheyHear You.Community Partner License Survey
"Talk. They Hear You." Newsletter Survey New 240 12 0 Form and Instruction “Talk. They Hear You.” Newsletter Survey
Campaign Partner Evaluation Focus Group New 16 16 0 Form and Instruction Campaign Partner Evaluation Focus Group
Parent Evaluation Focus Group New 16 16 0 Form and Instruction Parent Evaluation Focus Group
Parental Informed Consent and Assent New 1000 40 0 Form and Instruction Parental Informed Consent and Assent
Parents Night Out Participant Survey New 1000 120 0 Form and Instruction Parents Night Out Participant Survey
Parents Night Out Materials Download Survey Modified 500 25 0 Form and Instruction Parents Night Out Materials Download Survey
Parents Night Out Presenter Survey New 200 16 0 Form and Instruction Parents Night Out Presenter Survey
Participant Consent/Assent New 1000 40 0 Form and Instruction Participant Consent/Assent
Policy Academy 6-Month Follow-Up Modified 28 19 0 Form and Instruction Six month Post Policy Academy Follow-up
Policy Academy Baseline Modified 28 19 0 Form and Instruction Policy Academy Baseline
Policy Academy Coach Post Coaching Form Modified 210 36 0 Form and Instruction Policy Academy Coach Post Coaching Survey
Policy Academy Focus Group Modified 28 28 0 Form and Instruction Evaluation Focus Group
Policy Academy Follow-Up Modified 28 28 0 Form and Instruction Post Policy Academy Follow-up
Policy Academy Participant Post Coaching Call Survey Modified 280 35 0 Form and Instruction Participant Post-Coaching Call Survey
Policy Academy Participant Post Training Form Modified 280 35 0 Form and Instruction Participant Post-Training Call Survey
Pre-Screener New 1000 80 0 Form and Instruction Pre-Screener
Screen4Success Screener New 1000 300 0 Form and Instruction Screen4Success Screener
State Survey Modified 51 944 0 Form and Instruction STOP State Survey
Talk. They Hear You"® Product Design Request Survey New 100 17 0 Form and Instruction TalkTheyHearYouProduct Design Request Survey
Talk. They Hear You. Mobile App Parent Survey New 200 24 0 Form and Instruction Talk.They Hear You Mobile App Parent Survey
Talk. They Hear You. Partner Feedback Survey New 86 15 0 Form and Instruction Talk. They Hear You. Partner Feedback Survey
Talk. They Hear You."Mobile App Satisfaction Survey New 200 10 0 Form and Instruction Talk.They Hear You.Mobile App Satisfaction Survey
Total burden requested under this ICR: 7751 1896 0  
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