Parents are the Key Teen Driving Safety Initiative

CDC and ATSDR Health Message Testing System

OMB: 0920-0572

IC ID: 212361

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
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IC Document
Information Collection (IC) Details

View Information Collection (IC)

Parents are the Key Teen Driving Safety Initiative 14 VV
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none Pediatrician Screener Attachment N - Pediatrician Screener - Screenshots.pdf Yes Yes Fillable Fileable
Form and Instruction none Parent Message Testing Moderator's Guide Attachment I - Parent Message Testing (Moderator) Guide - Screenshots.pdf Yes Yes Fillable Fileable
Form and Instruction none Parent Message Testing Moderator's Guide - Spanish Attachment J - Parent Message Testing (Moderator) Guide - Spanish - Screenshots.pdf Yes Yes Fillable Fileable
Form and Instruction none Pediatrician Message Testing Moderator's Guide Attachment K - Pediatrician Message Testing (Moderator) Guide - Screenshots.pdf Yes Yes Fillable Fileable
Form and Instruction none Parent Screener Attachment L - Parent Screener - Screenshot 7-22-14.pdf Yes Yes Fillable Fileable
Form and Instruction none Parent Screener - Spanish Attachment M - Parent Screener - Spanish Version - Screenshot 7-22-14.pdf Yes Yes Fillable Fileable

Health Illness Prevention

 

174 0
   
Individuals or Households
 
   100 %

  Requested 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 174 0 0 0 0 174
Annual IC Time Burden (Hours) 119 0 0 0 0 119
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Project Description Attachment A - Project Description.docx 07/16/2014
Burden Table Attachment B - Burden Table.docx 07/16/2014
Pediatrician Screener - word Attachment E - Pediatrician Screener.docx 07/16/2014
Parent Message Testing Moderator's Guide - word Attachment F - Parents Message Testing (Moderator) Guide.docx 07/16/2014
Parent Message Testing Moderator's Guide - Spanish - word Attachment G - Parents Message Testing (Moderator) Guide - Spanish Version.docx 07/16/2014
Pediatrician Message Testing Moderator's Guide - word Attachment H - Pediatricians Message Testing (Moderator) Guide.docx 07/16/2014
Parent email Attachment O - Parents Emails.docx 07/16/2014
Parent email - Spanish Attachment P - Parents Emails - Spanish Version.docx 07/16/2014
Pediatrician email Attachment Q - Pediatricians Emails.docx 07/16/2014
Expedited Review Form HMTS Expedited Review Form.pdf 07/16/2014
Parent Screener Attachment C - Parent Screener_CLEAN 7-22-14.docx 07/28/2014
Parent Screener - Spanish Attachment D - Parent Screener - Spanish Version_CLEAN 7-22-14.docx 07/28/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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