Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
NHTSA Form 2179 - Eligibility Questionnaire New 233 47 0 Form 2179
NHTSA Form 2180 - Informed Consent Document 1 New 16 4 0 Form 2180
NHTSA Form 2182 Wellness Questionnaire New 300 10 0 Form 2182
NHTSA Form 2183 - Questionnaire 1 New 80 8 0 Form 2183
NHTSA Form 2184 - Driving Behavior Assessment & Questionnaire 2 New 16 23 0 Form 2184
NHTSA Form 2185 - Questionnaire 3 New 83 14 0 Form 2185
NHTSA Form 2186 - Driving Behavior Assessment [Study 2 & 3] & Questionnaire 4 New 83 173 0 Form 2186
NHTSA Form 2267 - Intake & Eligibility Confirmation New 100 8 0 Form 2267
NHTSA form 2181 - Informed Consent Document 2 New 83 21 0 Form 2181
Total burden requested under this ICR: 994 308 0  
To view an IC, click on IC Title