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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Middle School Perspectives on Sexual Health Education in Fort Worth Independent School District
Agency IC Tracking Number:
0920-17TK
IC Status:
New
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
Form and Instruction
N/A
Middle School Focus Group Guide
Att 3-Middle School Focus Group Guide.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
48
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
48
0
48
0
0
0
Annual IC Time Burden (Hours)
72
0
72
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Authorizing Legislation: Public Health Service Act
Att 1-PHS Act Legislation.pdf
02/16/2017
60-day FRN for the generic 0920-0840 clearance
Att 2-60 Day FRN.pdf
02/16/2017
Consultants on the FWISD Information Collection
Att 4-Consultants_on_the_IC.docx
02/16/2017
IRB Approval
Att 5-Documentation of IRB Approval.pdf
02/16/2017
Parental Consent Form
Att 6-Parental Consent Form.docx
02/16/2017
Student Verbal Assent
Att 7-Student Verbal Assent Language.docx
02/16/2017
Changes since Spring 2016 Information Collection
Att 8-Description of Changes.docx
02/16/2017
FWISD Non-disclosure Agreement
Att 9-NonDisclosure Agreement.pdf
02/16/2017
Supporting Statement Part A
SSA-2017-02-16.docx
02/16/2017
Supporting Statement Part B
SSB-2017-02-15.docx
02/16/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.