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It's a Noisy Planet. Protect Their Hearing.® Campaign: Mall Interview Surveys
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Adolescent Recruitment Screener and Consent Form NIDCD_NP Screener_Adolescent 1 13 15.docx No   Paper Only
Form and Instruction 2 Parent/Guardian Recruitment Screener and Consent Form NIDCD_NP Screener_Parent 1 13 15.docx No   Paper Only
Form 3 Adolescent Interview Survey NIDCD_NP Survey_Adolescent 12 19 14.docx No   Paper Only
Form 4 Parent/Guardian Interview Survey NIDCD_NP Survey_Parent 12 19 14.docx No   Paper Only

Health Health Care Services

 

86 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 86 0 86 0 0 0
Annual IC Time Burden (Hours) 29 0 29 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Noisy Planet Fast-Track Template NIDCD_NP Fast track template 2014(3)[1].docx 01/20/2015
Parent Blue Wave Fact Sheet NIDCD NP Parents Blue Wave Fact Sheet 12 19 14.pdf 01/20/2015
Adolescents Green Wave Fact Sheet NIDCD NP Adolescents Green Wave Fact Sheet 12 19 14.pdf 01/20/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.