View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

[NCIPC] Adverse Childhood Experiences Prevention Message Development 0920-1154-24IP
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1154 (24IP) ACEs Survey and Consent Att 1. ACEs Survey and Consent__OMB Edited 12.2.24.docx Yes Yes Fillable Fileable
Other-Screenshots Att 2. ACEs Survey Screenshots_8.7.24ka.docx No   Printable Only
Form and Instruction 0920-1154 (24IP) ACEs Focus Group Participant Screener Att 3. ACEs Focus Group Participant Screener_OMB Edited12.2.24.docx Yes Yes Fillable Fileable
Form and Instruction 0920-1154 (24IP) ACEs Focus Group Consent Form Att 4. ACEs Focus Group Consent_v3.docx Yes Yes Fillable Fileable
Instruction Att 5. ACEs Focus Group Guide_v2.docx Yes Yes Fillable Fileable
Form and Instruction 0920-1154 (24IP) ACEs Partner Interview Consent Form Att 6. ACEs Partner Interview Consent Form_v3.docx Yes Yes Fillable Fileable
Form and Instruction 0920-1154 (24IP) ACEs Partner Interview Guide Att 7. ACEs Partner Interview Guide_v2.docx Yes Yes Fillable Fileable

Health Health Care Services

 

200 0
   
Individuals or Households
 
   100 %

  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 200 0 200 0 0 0
Annual IC Time Burden (Hours) 86 0 86 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA (24IP) ACE Prevention Message SSA_OMB Corrected 12.02.24.docx 12/11/2024
SSB (24IP) ACE Prevention Message SSB__8.7.24ka.docx 09/17/2024
ACEs Messages for Testing (24IP) Att 8. ACEs Messages for Testing_v1.docx 09/17/2024
Project Determination (24IP) Att 10. ACEs Non-Research determination.docx 09/17/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.