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Information Collection

Midwest Modified Index Collaboration Pre-test and Follow-up

IC 204265 under ICR 201209-0920-008 · OMB 0920-0954.

Documents and Forms
Document Name
Document Type
Form
Form
IC Document
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Midwest Modified Index Collaboration Pre-test and Follow-up
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Midwest Modified Index Collaboration Pre-test and Follow-up F7a_screenshots Midwest FASD RTC Modified Index of Interdisciplinary Collab, 3 mo Follow-up - online survey.pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

75 0
   
Individuals or Households
 
   50 %

  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 150 0 150 0 0 0
Annual IC Time Burden (Hours) 25 0 25 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Midwest Modified Index Colloboration Pre-test and Follow-up - Word F7_Midwest FASD Regional Training Center Modified Index of Interdisciplinary Collab, Pre-Test.docx 09/19/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.