View Information Collection (IC)
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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Youth Screener and Consent for Online Outcome Survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Longitudinal Web Consent and Assent
Attachment 5c_Longitudinal Web Consent and Assent.docx
Yes
Yes
Printable Only
Other-Longitudinal Web Consent 18+ Year Old Youth
Attachment 5d_Longitudinal Web Consent 18+ Year Old Youth.docx
Yes
Yes
Printable Only
Other-Outcome Web Screener
Attachment 3_Outcome Web Screener.docx
Yes
Yes
Fillable Fileable
Other-Cross Sectional Social Media_Snowball 15+ Youth
Attachment 5e_Cross Sectional Social Media_Snowball 15+ Youth.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
39,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
39,000
0
37,635
0
0
1,365
Annual IC Time Burden (Hours)
3,249
0
2,225
0
0
1,024
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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